From the Guidelines
Tendon rupture is primarily caused by a combination of acute trauma and chronic degeneration, with the latter significantly increasing the risk of rupture due to weakened tendons. According to 1, tendon injury may be secondary to acute trauma or repetitive loading, with the latter being the most common type of tendon problem. Chronic degeneration, or tendinopathy, is a key factor in increasing the risk of tendon rupture, as it weakens the tendon and makes it more vulnerable to tearing even with normal activities.
Causes of Tendon Rupture
- Acute trauma from sports injuries, falls, or accidents where tendons are stretched beyond their limits
- Chronic degeneration (tendinopathy) due to repetitive loading or overuse
- Certain medications, such as fluoroquinolone antibiotics and corticosteroid injections, which can weaken tendon structure and increase rupture risk
- Medical conditions like rheumatoid arthritis, diabetes, gout, and hyperparathyroidism, which can affect tendon integrity
- Age-related degeneration, as tendons naturally lose strength and elasticity over time
- Anatomical factors, such as poor blood supply to certain tendons, which can impair healing and make them more susceptible to rupture
Prevention Strategies
- Proper warm-up before exercise
- Gradual intensity increases in physical activities
- Appropriate footwear
- Strength training to support vulnerable tendons As noted in 1, most patients with overuse tendinopathies fully recover within three to six months with relative rest, icing, and eccentric strengthening exercises, highlighting the importance of early intervention and prevention strategies to reduce the risk of tendon rupture.
From the Research
Causes of Tendon Rupture
- Tendon rupture can be caused by a combination of intrinsic and extrinsic risk factors, including natural aging, which leads to chronic degeneration of the tendon 2
- Decreased blood flow and increased stiffness with aging can decrease the ability of the tendon to withstand stress, making it more prone to rupture 2
- Noninflammatory tendinosis and chronic tendinopathy are two separate processes that can contribute to tendon degeneration and subsequent rupture 2
- Sports participation, particularly activities involving eccentric loading and explosive plyometric contractions, can increase the risk of tendon rupture 2, 3
- Predisposing factors such as male gender, age (typically 4th to 5th decades of life), and certain medical conditions can also increase the risk of tendon rupture 2, 4
Mechanisms of Tendon Rupture
- Rupture typically occurs due to a sudden, forceful contraction of the muscle, such as during running, jumping, or agility activities 2
- The mechanism of rupture can also be related to chronic degeneration of the tendon, which can weaken the tendon and make it more susceptible to rupture 2, 5
- The use of corticosteroid injections can also increase the risk of tendon rupture, particularly in the case of patellar tendinopathy 6
Risk Factors for Tendon Rupture
- Intrinsic risk factors, such as tendon degeneration and chronic tendinopathy, can increase the risk of tendon rupture 2, 5
- Extrinsic risk factors, such as sports participation and certain medical conditions, can also increase the risk of tendon rupture 2, 4
- Age and gender can also play a role in the risk of tendon rupture, with males in the 4th to 5th decades of life being at higher risk 2, 4