04/27/2014
A great article about a common injury.
Musculoskeletal Monday by Romain Hayem, BSc. and MSc.-student:
Part 1 What exactly is a tendinopathy?
Tendinopathy is a common overuse injury, which commonly affect lateral and medial epicondyles, rotator cuff, biceps, Achilles, hamstring, gluteus medius or patellar tendons and include De Quervain's and ITB syndromes. They are primarily caused by repetitive or excessive mechanical loads. Tendons become progressively damaged, causing focal degeneration, partial tears, and ruptures to tendon fibres (and possibly to local vessels). The role of inflammation is unclear, as inflammatory mediators may still be implicated, ev
en in the absence of inflammatory cells. Finally, neuronal inputs to immune cells may also modulate proliferative and tissue reorganisation processes. Tendinopathies are characterised by a gradual onset of tendon stiffness, activity-related pain, sometimes local tendon swelling and crepitations, and impaired performance. Clinical examination reveals pain with stretching, isometric contractions and palpation. The use of MRI or US imaging is limited, due to poor correlations with symptoms, but may help to confirm an unclear diagnosis.
Affected tendons show thinner and disorganised collagen fibres, increased production of collagen and matrix proteins, increased number of active tenocytes, and neovascularisation of the tendon. The pain mechanism itself is not wholly elucidated (nociceptor stimulation by inflammatory, nociceptive or immune mediators). Part 2 will focus on treatment and management options > from Kaux et al.; Journal of Sports Science and Medicine 10 (2011) 238-253. All rights reserved to JSSM.
