This workshop is designed to show delegates how, why and when polidocanol should be used. Tendons are structures that connect muscle to bone. They also carry tensile forces from muscle to bone. They carry comprehensive forces when wrapped around bone like a pulley. Tendon length varies in all major groups and tendon length is practically the discerning factor where muscle size and potential muscle size is concerned. When tendons undergo tendon change such as tendinosis, tendonopathy etc new blood vessels are introduced to repair the damaged region. This tendon injury results from gradual wear and tear to the tendon from overuse and/or ageing.
When new blood vessels infiltrate the traumatised region of the tendon, the process of neo-vascularisation begins. Tendons have very low blood supply, as there function is to attach and load muscle to bone, so when blood supply is increased into a compromised area small nerves also infiltrate this area therefore causing pain. Colour Doppler ultrasound is used to demonstrate these infiltrating vessels. They are identified and consequently sclerosed / obliterated immediately. This is done by guiding the needle, under ultrasound guidance into the " feeder" vessel/s. Polidocanol ( Aethroysklerol® 2% Marcaine ® 0.5% plain , AstraZenica , North Ryde, Australia ) is a sclerosing agent that is used, under ultrasound guidance to sclerose neo-vascularisation within tendons.
The main tendons to date that have responded in a positive way to sclerosing techniques are the "loading "tendons. These comprise of the Patellar tendon, Quadriceps tendon ( at the patella insertion) Achilles tendon and Common extensor origin at the lateral epicondyle origin of the elbow.