Effect of cyclic training model on terminal structure of rabbit Achilles tendon: an experimental study

Objective 　To observe the effect of cyclic training on histomorphology of the terminal structure of rabbit Achilles tendon, and explore its preventive effect on training-based enthesiopathy. Methods 　Seventy-two Japanese white rabbits were randomly assigned to four groups: control group, jumping group, running group and cyclic training group, 18 for each. Three rabbits of each group were sacrificed at the 2nd, 3rd, 4th, 6th, 8th and 10th week. The terminal insertion tissues of bilateral Achilles tendons were harvested from these rabbits for observing the pathomorphological changes under light microscope, and pathological scoring and statistical analysis were carried out. Results 　Light microscopy showed that the tendon fibers and fibrocartilage in the Achilles tendon insertion region were severely damaged in the jumping group, and though the tendon fibers were damaged severely, the injury to the fibrocartilage was comparatively less serious in the running group. The injuries to the tendon fibers and fibrocartilage were milder in the cyclic training group than in the jumping group and running group. In the 2nd, 3rd, 4th, 6th and 8th week, the histopathology score of insertion of Achilles tendon was 1.17±0.12, 2.19±0.15, 3.23±0.20, 4.66±0.16, 4.71±0.18, 4.63±0.13 respectively in the jumping group, and 1.16±0.13, 1.15±0.14, 2.18±0.12, 2.99±0.15, 3.98±0.16, 4.01±0.12 respectively in the running group. Increase in pathological score appeared earlier in the jumping group than in the running group, and a significant increase began at the 3rd week. The difference in pathological score between the two groups originated mainly from the changes in the tidemark. In the 2nd, 3rd, 4th, 6th, 8th and 10th week, the pathological score of Achilles tendon insertion was 1.13±0.14, 1.16±0.17, 1.15±0.13, 2.18±0.13, 2.17±0.12, 2.92±0.11 respectively in the cyclic training group, and they showed no significant changes as compared with control group at the early stage, but there was an increase at the late stage of the training (6 weeks later), however the score values were lower than those in the jumping group and running group. These changes in score were originated mainly from pathological changes in the paratenon and tidemark. Conclusions 　Jumping training could lead to severe injury to the fiber tissue and fibrocartilage, while running training might result in severe injury to Achilles tendon insertion structure and lighter injury to the fibrocartilage part. Cyclic training model provides suffcient time for repair and reconstruction of Achilles tendon insertion structure, and decrease the severity of the injury to Achilles tendon insertion region. Therefore, use of cyclic training could not only effectively prevent training-based enthesiopathy, but also accelerate the remodeling of the tissue in the insertion region, thus strengthen the repair ability of Achilles tendon against injury.