Tendinopathy

Your body has parts that help you move.

Sometimes these parts get sore. This can happen if you do too much. It can make you feel pain or swelling.

This soreness can happen in many places. It might be in your shoulder or elbow. It can also happen in your wrist, hip, knee, or ankle. It often hurts more when you move.

Some people are at higher risk. This includes athletes and musicians. People who do hard work can get it too. Older people get it more often.

To feel better, you may need to rest. Doctors might suggest special exercises. Some people use braces or medicine for the pain. Most people feel better in a few months.

Your body has parts called tendons. These parts help you move. Sometimes, tendons can become sore or swollen. This is called tendinopathy.

This often happens from doing the same thing many times. It can also happen after an injury. People who are athletes or musicians might get it. People who do hard manual labor are also at risk. Older people see this more often too. It can happen in your shoulder, elbow, or wrist. It also affects your hip, knee, or ankle.

When you have this, it might hurt to move. You might feel heat or see swelling. Doctors use tools like ultrasound to look at the tendons. An ultrasound uses sound waves to see inside. This helps them check for damage or tears.

Most people feel better with rest. You might use medicine for the pain. Some doctors suggest physiotherapy, which is special exercise to get strong. Using weights or bands can help more than just using your body weight. About 80% of people recover in six months.

Caption: A diagram showing a sore tendon and a torn tendon.

Tendinopathy is a common disorder that affects your tendons. Tendons are the parts of your body that connect muscles to bones. When they are hurt, you might feel pain, swelling, or stiffness. This pain often gets worse when you try to move. It can happen in many places, like your shoulder, elbow, or wrist. It can also affect your hip, knee, or ankle.

How does this happen? Often, it comes from an injury or doing the same movement many times. This is sometimes called overuse. People who do manual labor, play music, or play sports are at higher risk. Even things like diabetes or certain medicines can be causes. For example, some antibiotics called fluoroquinolones are linked to tendon problems. In some cases, these medicines can cause the Achilles tendon to rupture, or tear apart.

Scientists are still learning exactly how tendinopathy works. They used to call it "tendinitis," which means there is inflammation. Inflammation is when the body sends blood and cells to a hurt area. However, many doctors now use the word "tendinosis." This is because they found that the tendon tissue is often just breaking down or becoming disorganized. Instead of being swollen with inflammation, the tendon's structure changes. The tiny fibers that make up the tendon can become weak or disrupted.

Doctors use different ways to find out if you have this condition. They look at your symptoms, like heat or redness around a joint. They might also use medical imaging to see inside your body. One common tool is an ultrasound. An ultrasound uses sound waves to create a picture of your tissues. This helps doctors see if a tendon is thick or has tiny tears.

The good news is that most people can get better. About 80% of people recover completely within six months. Treatment often starts with rest to prevent more damage. You might also use ice, compression, or special braces. Many people use physiotherapy, which is a type of exercise therapy. Using weights or resistance bands can be very helpful for strengthening. Some doctors might also suggest medicine to help with the pain.

Tendinopathy is a medical disorder involving the tendons in the body. Tendons are the tough tissues that connect your muscles to your bones. When these tissues are damaged, they cause pain, swelling, and impaired function. This condition is very common and affects many different parts of the body. It often occurs around the shoulder, the elbow, the wrist, or the hip. It can also affect the knee or the ankle.

Many people experience pain that becomes worse during or after physical activity. You might feel tenderness when a doctor touches the area. Some people feel a burning sensation around the whole joint. You might even see swelling, redness, or heat in the area. In some cases, visible knots can form around the joint. The area may also feel stiff the day after movement. This happens because muscles often tighten up after the tendon moves.

There are different ways to understand what is happening inside the tissue. For a long time, people used the term "tendinitis." The suffix "-itis" means there is inflammation, which is the body's response to injury. However, scientists have found that many cases are actually "tendinosis." This term describes a process where the tendon tissue degenerates. Instead of active inflammation, the collagen fibers become disorganized. In these cases, the healthy tissue is replaced by a messy arrangement of collagen. This can include an increase in type III collagen instead of the usual type I.

Scientists are still studying the exact biological mechanisms of tendinopathy. It is considered a multifactorial condition, meaning many things can cause it. One theory involves tensile overload, which is too much pulling force on the tendon. Another idea is load-induced ischemia, where the blood supply is affected by pressure. There are also theories about thermal damage or the way cells called tenocytes behave. At a molecular level, certain chemicals called cytokines might be involved. For example, a chemical called IL-1β can reduce the expression of collagen in human tenocytes. This can lead to the breakdown of the extracellular matrix, which is the structure surrounding the cells.

Several factors can increase the risk of developing this condition. Repetitive activities or a single sudden injury are very common causes. People who perform manual labor, musicians, and athletes are at higher risk. Certain health conditions like diabetes, arthritis, or gout can also play a role. Obesity, or having a high amount of body fat, has been linked to more cases. Even some medicines can be a factor. For example, fluoroquinolone antibiotics are associated with an increased risk of tendon injury. In some cases, these medicines can lead to a tendon rupture. A review found that these drugs affect large load-bearing tendons in the lower limb. Specifically, the Achilles tendon can rupture in about 30% to 40% of these cases.

Doctors use several methods to diagnose the problem. They start by examining your symptoms and how you move. They may also use medical imaging to see the internal structure of the tendon. Ultrasound is a popular tool because it is safe, fast, and affordable. Ultrasound uses sound waves to create images of the tissue. It can show if a tendon is thickening or if there are tiny tears. Doctors can also use Color Doppler ultrasound to look at blood flow. This helps them see changes in vascularity, which is the presence of blood vessels.

Treatment is usually conservative, meaning it focuses on non-surgical methods. Rest is very important to prevent further damage to the tendon. Many people use non-steroidal anti-inflammatory drugs, or NSAIDs, to help manage pain. Physical therapy is also a very common way to recover. Research shows that using weights or resistance bands is often more effective than just using body weight. Some doctors may suggest using a brace or a splint to support the area. In some cases, steroid injections might be used to improve pain and function in the short term. However, these injections can make the tendon weaker over time. For some patients, surgery may be necessary if other treatments do not work.

Most people have a very good prognosis for recovery. About 80% of patients with overuse tendinopathy recover completely within six months. Initial recovery from an injury often happens within a few days to a few weeks. However, if the condition becomes tendinosis, it can take longer to heal. This happens when the acute healing phase ends but the area is not fully repaired. Tendinopathy is a significant issue in healthcare. It is responsible for up to 30% of visits to sports doctors and musculoskeletal providers. While it is common in athletes, it is also becoming more common in people who are not active.