Strictly speaking Tendinopathy as the name suggests is a disease (pathology) of the tendon (tendon). The tendon is the anatomical structure that connects the muscle to the bone, if the connection is from bone to bone it is called ligament. Therefore, the mechanical function is to transmit the force performed by the muscle to the bone so that the joint can move. The incidence of tendinopathy is 30-50% of all sports injuries according to various authors.
What are the causes of tendinopathy?
Mainly, there are two fundamental causes: one general and the other local.
General causes: among the general causes that affect the tendon, there can be systemic diseases such as increased blood cholesterol, diabetes, increased uric acid, rheumatic diseases… or taking certain medications, including antibiotics (ciprofloxacin or similar, certain drugs to lower cholesterol, chemotherapy for the treatment of cancer…).
Local causes: local causes are characterized by the concentration of the mechanical load in a certain area of the tendon during physical activity. This causes damage to the tendon and activation of the repair mechanisms. If these are defective, tendinopathy occurs. The concentration of loads at the local tendon level occurs as a consequence of the technical sports gesture, morphology of the lower limb, use of inappropriate sports equipment…
What are the symptoms of tendinopathy?
A tendinopathy can present itself in three ways, being the form of finding the following ones. – Finding during the exploration of a joint affected by another cause (such as a ligament or meniscus injury…) an alteration in the tendon structure may be found asymptomatic, i.e., without pain. In the medical field, this is called a finding, since the joint is studied looking for a lesion and another one is found that does not present symptoms.
– Progressive form of presentation: classically described in four stages
- In the first stage, the athlete has pain after physical exercise when he/she cools down.
- The second stage or phase is when the tendon hurts before and after the sport, but during the physical exercise the pain disappears, being this the last phase in which the tendinopathy allows to do sport.
- In the third phase, the tendon hurts before, during and after physical exercise, and does not allow normal sports activities.
- In the fourth phase, a tendon rupture has occurred, on a degenerated tendon base.
– Acute, abrupt presentation. During physical exercise, the athlete feels a sharp pain in the tendon. This indicates that at the very least, there is a partial rupture of the tendon and from this event, there is pain in the affected tendon.
How is tendinopathy treated?
Nowadays there is a great diversity of treatments, although each tendinopathy has to be treated by the specialist in Medicine and traumatology of the sport in an individualized way.
Parameters such as the time of onset of symptoms, whether the patient has a history of general illness or is taking drugs, whether the onset is abrupt or aggressive, whether the type of pain is superficial or deep, the type of tendon -the Achilles tendon will not behave the same as the patellar tendon-, whether or not there is pathological neovascularization, the existence or not of a degenerative focus in the tendon, the location of the injury… must be taken into account.
Can tendinopathy be prevented?
Mechanical causes, sports or local involvement are easier to prevent, however it is more difficult when it is the repercussion of a general problem that collaterally also damages the tendon. The characteristics of the tendinopathy must be investigated and at the same time the causes of the tendinopathy must be investigated to prevent and avoid a relapse.