Tendinopathy Signs and Symptoms
Introduction
- A clinical syndrome characterized by tendon thickening & localized tendon pain, swelling, or impaired performance
- Usually a temporary condition if treated early but may also be recurrent or chronic
- Result either from acute trauma (eg rupture, laceration) or repetitive overload/overuse
Definition
Tendinitis
- An inflammatory response that occurs in tendons after vascular disruption, resulting from microscopic, partial, or complete rupture of the tendon
- Although inflammatory reactions exist, most patients have prolonged symptoms before consulting a physician & the acute inflammation has already subsided & has been replaced by disordered collagen arrangement w/ increased proteoglycan & neovascularization
- Occur during acute stage & is usually not long-lasting
- Refers to the histopathologic finding of tendon degeneration
- Most common type of tendon problem
- Characterized by chronic degenerative changes in the tendon tissue that reflect scarring &/or failed healing response
- The classic inflammatory reaction is typically absent in overuse tendinopathy, or only minimally present in adjacent peritendinous or bursal tissue
Signs and Symptoms
- Pain
- Weakness in the joint
- Tenderness
- Swelling, erythema, warmth
Risk Factors
- Often divided into intrinsic factors which refer to the properties of an individual’s tendon or healing capacity & extrinsic factors which refer to the load placed on the tendon
- Age
- Tendons become less flexible w/ age & become more prone to damage
- Increasing age is also associated w/ increased risk of delayed recovery
- Gender
- May be caused by a combination of hormonal influences, biochemical variables, sporting or occupational behaviors
- Obesity
- In general, overweight or obese patients have increased risk of developing tendinitis
- Medical conditions
- Patients w/ preexisting illness such as tendon lesions, arthritis, gout, thyroid disease & diabetes
- Fluoroquinolone treatment
- Several case reports of tendinopathy, particularly Achilles tendinopathy, & some reports of tendon rupture in patients receiving fluoroquinolone treatment
- Work-related factors
- Physical factors: intense, repeated & sustained exertion; insufficient recovery time between activities; starting a new job or returning to work after an extended period of time away; poor environmental conditions; inadequate equipment
- Psychosocial factors: monotonous work, time pressure, high work load