Hi-TENS and tendinopathy in female basketball players

Thanks to the design of its electrode, Hi-TENS by R-Shock delivers rapid and targeted energy. Additionally, the combination of two different currents, a TECAR current and a low-frequency pulse current, mean it can be used for different applications, ranging from acute to chronic.

With thousands of different movements per game, including changes in direction and pace every two to three seconds, basketball is the number one sport responsible for injuries for women. Jumps represent 3% of playing time, which is as important as volleyball.

64% of these injuries relate to the lower limbs, made up of a majority of ankle sprains, muscle lesions or tendinopathies.[1]

Clinical case: tendinosis in a female player from the French basketball team

Prior to looking at this case, it’s necessary to recall the pathophysiology of the tendon. In practice, the tendon is not an inert structure, it is living, and modifies, regenerates and repairs itself. It is subject to uniaxial and multi-directional stresses. Its cells keep it in a permanent state of homeostasis, that’s to say a balance between synthesis and degradation of the extracellular matrix.

The tendon adapts to an appropriate workload, including during training. The balance between workload and intensive effort must therefore be appropriate. An imbalance will lead to a risk of pathologies: from reactive tendinopathy to a remodeled tendon, then to degenerative tendinopathy. In fact, an excessive load will lead to microlesions aggravated by factors such as nutritional status and dehydration.

This intersection of constraints gives the tendon a specific structure, with different parts exhibiting different pathologies: tendinosis (affecting the body of the tendon), paratenonitis (the paratenon) and enthesopathy (the connection points). An evaluation of the tendinopathy, including research into the mechanism that has caused the lesion and the associated mechanical stresses, combined with questioning and a clinical exam, will enable the type of tendinopathy and its severity to be established.

In this case, the 38-year-old player was the shooting guard and had been professional since 2009. Her position necessitated a lot of accelerations and decelerations. In her history, she had had very few injuries, other than a myo-aponeurotic lesion of the soleus a year previously. The clinical examination revealed pain when getting up which developed during the course of training and had difficulty resolving afterwards. On palpation, the tendon was thickened and internally painful.

The contribution of Hi-TENS by R-Shock

The benefits of Hi-TENS by R-Shock on tendinosis are:

• Immediate pain relief

• Revascularization

• Collagen synthesis

During treatment the French Federation of Basketball’s physiotherapist used Hi-TENS by R-Shock alongside fascial techniques (crochetage, massage etc), both in the consultation room and also before matches.

Results:

– Immediate impact on the pain (during the second session the player herself requested pre-match treatment sessions)

– Lasting effect over the duration of the treatment (remodeling of the tendon achieved after three weeks)

A complementary course of functional treatment was proposed in parallel, with an adapted recovery protocol (increasing the stress progressively).[2] The use of Hi-TENS by R-Shock therefore enabled the player to return painlessly and very quickly to the court.

[1] Les blessures liées à la pratique du basketball : revue systématiqe des études épidémiologiques, C.Foschia, F.Tassery, V.Cavelier, A.Rambaud, P.Edouard (https://www.sciencedirect.com/science/article/abs/pii/S0762915X19300725)

[2] Current Clinical Concepts : Conservative Management of Achilles Tendinopathy, Karin Grävare Silbernagel, PhD, PT, ATC ; Shawn Hanlon, MS, ATC, CSCS ; Andrew Sprague, DPT, MS, PT ; J Athl Train (2020) 55 (5): 438–447.