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Open Access Research article

Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments

M Terry Loghmani1* and Stuart J Warden12

Author Affiliations

1 Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan Street, CF-326, Indianapolis 46202, IN, USA

2 Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan Street, Indianapolis 46202, IN, USA

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BMC Complementary and Alternative Medicine 2013, 13:240  doi:10.1186/1472-6882-13-240

Published: 28 September 2013

Abstract

Background

Ligament injuries are common clinical problems for which there are few established interventions. Instrument-assisted cross fiber massage (IACFM) was recently shown to accelerate the restoration of biomechanical properties in injured rodent knee medial collateral ligaments (MCL). The current study aimed to investigate the influence of IACFM on regional perfusion and vascularity in the vicinity of healing rodent knee MCL injuries.

Methods

Bilateral knee MCL injuries were induced in female Sprague–Dawley rats. Commencing 1 week post-injury, 1 minute of IACFM was introduced unilaterally 3 times/week for 3 weeks. The contralateral injured MCL served as an internal control. Regional tissue perfusion was assessed in vivo throughout healing using laser Doppler imaging, whereas regional microvascular morphology was assessed ex vivo via micro-computed tomography of vessels filled with contrast.

Results

IACFM had no effect on tissue perfusion when assessed immediately, or at 5, 10, 15 or 20 min following intervention (all p > 0.05). However, IACFM-treated hindlimbs had enhanced tissue perfusion when assessed 1 day following the 4th and 9th (last) treatment sessions (all p < 0.05). IACFM-treated hindlimbs also had greater perfusion when assessed 1 wk following the final treatment session (32 days post-injury) (p < 0.05). Subsequent investigation of microvascular morphology found IACFM to increase the proportion of arteriole-sized blood vessels (5.9 to <41.2 μm) in the tibial third of the ligament (p < 0.05).

Conclusions

These findings suggest IACFM alters regional perfusion and vascularity in the vicinity of healing rodent knee MCL injuries. This effect may contribute to the beneficial effect of IACFM observed on the recovery of knee ligament biomechanical properties following injury.

Keywords:
Angiogenesis; Blood flow; Knee; Laser doppler imaging; Ligament; Massage