Tendinopathy

 

Tendinopathy is a general term that describes tendon degeneration characterized by a combination of pain, swelling, and impaired performance. Other names such as tendinosis and tendinitis are also used.

A lot of research is being carried out into the cause and mechanism of tendinopathy. It is widely accepted that a combination of  over-use and inadequate tendon repair predisposes the tendon to micro-tears and degeneration.

There are several hundred tendons in the body and theoretically any of these could be affected. However the common sites are following:

1. Rotator cuff (mainly supraspinatus tendon) in the shoulder,

2. Thumb extensor (De queveins) of the wrist

3.Common extensor tendon of the elbow (tennis elbow)

4. Common flexor tendon of the elbow (golfer's elbow)

5.  Patellar (jumpers knee) and quadriceps tendons of the knee

6. Achilles' tendon

In most resistant cases the difficulty lies in identifying the causes of the problem which could lead to improved recovery and success in treatment. Particular aim is to identify any bio-mechanical issues which might be predisposing to the problem. Occasionally the problem might lay elsewhere or be inflammatory in nature.

Treatment consists of activity modification, relative rest, ice, stretching, and strengthening. The main stay of treatment is through rehabilitation (physiotherapy and activity modification).

However, in resistant or recurrent cases steroid, hyaluronic acid or PRP injections can be considered to aid recovery and to engage with physiotherapy after careful discussion of the merits, limitations and risks with each type of treatment.