Changes of Achilles Midportion Tendon Microcirculation after Repetitive Simultaneous Cryotherapy and Compression Using a Cryo/Cuff

Abstract

Background Cryotherapy and compression have been shown to decrease pain and improve function. The dosage and timing of these options remain unclear. Purpose To examine the effects of a standardized compression and cryotherapy device (Cryo/Cuff) on midportion Achilles tendon microcirculation during intermittent administration. Study Design Descriptive laboratory study. Methods Twenty-six subjects were included (13 men and 13 women; age, 32.3 ± 12 years; body mass index, 25.4 ± 5 kg/m2). Each underwent three 10-minute applications of the device, followed by a 10-minute recovery period. A continuous real-time assessment of parameters of Achilles tendon midportion microcirculation was performed with a laser Doppler spectrophotometry system. Results Superficial tendon oxygen saturation dropped significantly from 35.9 ± 21 arbitrary units (AU) to 13.5 ± 15, 15.9 ± 16, and 11.1 ± 11 AU (P =. 0001) during each period of cryo-compression, respectively. There was significant increase during the recovery period (55.4 ± 29, 65.2 ± 26, and 65.7 ± 27 AU; P =. 003), up to +83% of the baseline level. At 8-mm tendon depth, cryo-compression preserved local oxygen with -4% (P =. 001) of the baseline level and small but significant increased oxygen saturation of up to +13% (P =. 0001). Relative postcapillary venous tendon filling pressures were favorably reduced both superficially (57% ± 34%, 67% ± 27%, and 64% ± 38%, respectively; P =. 0004) and deep (76% ± 13%, 79% ± 11%, and 78% ± 18%, respectively; P =. 0002). Superficial capillary blood flow was reduced from 48.4 ± 48 to 5 ± 7, 4 ± 5, and 3 ± 4 AU at each period, respectively (–94%, P =. 0003), with increased flow during recovery periods of up to 58 ± 64, 58 ± 79, and 47 ± 71 AU, respectively (+20%, P =. 265). Deep flow was reduced from 197 ± 147 to 66.7 ± 64, 55 ± 46, and 43 ± 39 AU, respectively (–78%, P =. 0002) without increase during recovery periods. Conclusion Cryo/Cuff exerts beneficial effects on the microcirculatory level of the midportion Achilles tendon with decreased capillary blood flow, preserved deep tendon oxygen saturation, and facilitated venous capillary outflow.