As a clinician, you are attempting to produce permanent elongation in a severely contracted flexor digitorum profundus tendon

Which of the following general strategies concerning treatment will be least effective in achieving permanent lengthening of the tendon?
a. Apply force slowly to decrease the stiffness of the tendon.
b. Apply a short duration force, keeping the force in the elastic range.
c. Apply enough force to cause microfailure of some fibers in the tendon.
d. Use a splint that will apply a low load to the tendon (at the beginning of the elastic range) for 3 weeks.

ANS: B
If a muscle has undergone prolonged shortening and is now considered to be in a state of
contracture, one must make permanent changes in the stress-strain curve of that tendon in order to
regain the length of the structure. There are several ways to accomplish changes in the stress-strain
curve of a tendon. One of the most effective ways to apply a low load over a long period of time is
to utilize the phenomenon of creep to cause permanent deformation. Another way to address this
issue is to push the fibers to the end of the plastic range or slightly into the plastic region of the
stress-strain curve, causing microfailure of the structure and thus causing permanent change in
length.