Healing and prophylactic efficacies of topical composite herbal medication on overuse-induced Achilles tendinosis

Abstract

Traditional Chinese herbal medication (TCM) has long been used for treating tendon injuries. However, information on its healing effect on overuse-induced Achilles tendinosis is scarce. In addition, former investigations focused mainly on treatment upon occurrence of injuries but information on prophylactic measures was limited. Thus, this study aimed to explore both healing and prophylactic efficacies of a composite traditional Chinese herbal extract on mechanical and morphology performance of overuse-induced Achilles tendinosis. 40 Sprague-Dawley rats were randomly allocated into 4 equal groups of cage control (CC), exercise-only (EX), exercise with pre-exercise herbal treatment (Pre-HB) and exercise with post-exercise herbal treatment (Post-HB). EX, Pre-HB and Post-HB rats were subjected to daily upper body suspended downhill treadmill running for 8 weeks. In addition, 4 weeks of TCM treatment with herbal formula comprised Dipsaci Radix, Rhizoma Notoginseng, Flos Carthami and Rhizoma Rhei in the ratio 1:1:1:1 was provided to Pre-HB rats before running program whereas 6 weeks of TCM treatment was provided to Post-HB rats after running program. The cellularity, load-relaxation, stiffness and ultimate failure load (UFL) of Achilles tendons were evaluated. After treatment period, hypercellularity was found in EX specimens but not in CC, Pre-HB and Post-HB. Load-relaxation of Post-HB was similar to CC but significantly less than EX. No difference in stiffness was observed among the 4 groups but the UFL of CC and Pre-HB was significantly higher than that of EX. Thus, the current herbal formula had positive effects in both healing and prophylaxis for overuse-induced Achilles tendinosis in rats.