The term tendinopathy refers to a group of painful tendon disorders characterized by degenerative changes in the tendons, which result in pain, swelling and reduced function.
Tendinopathy is a broad term that includes both tendonitis (inflammation of the tendon) and tendinosis (degenerative changes in the tendon without significant inflammation).
Tendinopathy can occur in various tendons throughout the body, with the Achilles tendon, patellar tendon, rotator cuff tendons, and elbow being the most commonly affected.
Tendinopathy often results from repetitive motion or excessive stress on the tendon, leading to microtrauma and degeneration over time.
Tendons naturally undergo degeneration during aging, making older people more susceptible to tendinopathy.
Poor biomechanics, such as abnormal joint alignment or muscle imbalances, can increase the risk of tendinopathy.
Certain medical conditions (eg diabetes, rheumatoid arthritis) and medications (eg corticosteroids) can also increase the risk.
Symptoms and diagnosis of tendinopathy:
Pain and tenderness:
Tendinopathy usually presents with localized pain, tenderness, and swelling around the affected tendon.
Loss of function:
Tendinopathy can lead to reduced strength, limited range of motion, and difficulty performing certain activities.
Diagnosis is primarily based on a clinical examination, including a detailed medical history, physical assessment, and imaging techniques (eg, ultrasound, MRI) to assess tendon structure.
Treatment options for tendinopathy:
- Rest and activity modification: Temporarily avoiding activities that stress the tendon can help reduce symptoms and promote healing.
- Physical therapy: Targeted exercises to improve strength, flexibility and biomechanics are essential in tendon rehabilitation.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs can help relieve pain and reduce inflammation.
- Cryotherapy and heat therapy: Alternating applications of cold and heat can provide symptomatic relief and speed recovery.
- Extracorporeal Shock Wave Therapy (ESVT): High-energy shock waves stimulate healing processes within the tendon.
- Platelet-rich plasma (PRP) therapy: Concentrated platelets containing growth factors are injected into the tendon to promote tissue regeneration.
- Corticosteroid injections: May be used cautiously in certain cases to reduce inflammation and pain.
- Surgery: In severe cases, surgery may be required to remove damaged tissue or repair the tendon.
How can we prevent and avoid tendinopathy?
Gradual progression: Gradually increase the intensity and duration of exercise to allow the tendon to adapt and strengthen.
Proper technique and form: Ensure proper movement patterns and body mechanics during physical activities to reduce stress on the tendons.
Adequate rest and recovery: Allow enough time for rest and recovery between training or repetitive activities.
Strength and flexibility training: Regularly engage in exercises that target muscle strength and flexibility to maintain healthy tendons.
Appropriate equipment and footwear: Use appropriate equipment and footwear that provide adequate support and shock absorption.