From the Guidelines
Triggers for tendon problems, specifically tendinopathies, include overuse, increased activity, and load-related localized pain, which can be exacerbated by factors such as poor technique, inadequate warm-up, and cool-down routines, as well as anatomical issues like foot pronation or supination in the case of Achilles tendon problems. According to 1, the natural history of tendinopathies involves gradually increasing load-related localized pain coinciding with increased activity, suggesting that overuse is a primary trigger. Some common areas affected by tendinopathies include:
- The rotator cuff
- Medial and lateral elbow epicondyles
- Patellar tendon
- Achilles tendon These areas are prone to overuse injuries, especially in individuals who engage in repetitive activities or sports that involve running, jumping, or throwing. Managing these triggers involves relative rest of the affected area, icing, and eccentric strengthening exercises, as well as addressing any underlying anatomical or technical issues that may be contributing to the problem. It is also important to note that while topical and systemic nonsteroidal anti-inflammatory drugs can provide acute pain relief, they should be used with caution and not as a long-term solution, as stated in 1. Instead, focusing on prevention and addressing the underlying causes of tendinopathies can help reduce the risk of developing these conditions and improve overall quality of life.
From the Research
Triggers for Tendinopathy
- Intrinsic factors such as anatomic factors, age-related factors, and systemic factors can contribute to the development of tendinopathy 2
- Extrinsic factors including mechanical overload and improper form and equipment can also trigger tendinopathy 2
- Overuse or repetitive strain on the tendon can lead to tendinopathy, as it causes micro-tears in the tendon tissue 3
Risk Factors
- Age is a significant risk factor, as tendinopathy is more common in older adults 2
- Anatomic factors, such as poor foot mechanics or uneven leg length, can increase the risk of developing tendinopathy 2
- Systemic factors, such as diabetes or rheumatoid arthritis, can also contribute to the development of tendinopathy 2
Common Types of Tendinopathy
- Achilles tendinopathy is a common type of tendinopathy that affects the Achilles tendon 4, 5
- Rotator cuff tendinopathy is another common type that affects the tendons in the shoulder joint 5
- Lateral epicondylalgia, also known as tennis elbow, is a type of tendinopathy that affects the tendons in the elbow joint 5
Treatment Options
- Eccentric exercises have been shown to be an effective treatment for tendinopathy, particularly for Achilles tendinopathy 6
- Low-level laser therapy and extracorporeal shockwave therapy have also demonstrated moderate effectiveness in treating tendinopathy 6
- Corticosteroid injections may provide short-term pain relief, but their long-term effectiveness is limited and they may be contraindicated in some cases 5, 6