Tendinopathy Signs and Symptoms
Introduction
- A clinical syndrome characterized by tendon thickening, persistent localized tendon pain, swelling, and impaired performance
- Usually a temporary condition if treated early but may also be recurrent or chronic, with symptoms lasting over 3 months
Definition
- May follow an initial period of inflammation known as tendinitis
- Refers to a nonrupture tendon injury commonly resulting from repeated mechanical loading/overuse that occurs in workers and athletes (both recreational and professional)
- Refers to the histopathologic finding of tendon degeneration
- Characterized by chronic degenerative changes in the tendon tissue that reflect scarring and/or failed healing response
- The classic inflammatory reaction is typically absent in overuse tendinopathy or only minimally present in adjacent peritendinous or bursal tissue
- Increased participation in sporting activities among middle-aged adults have led to increased incidence
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 and extrinsic factors which refer to the load placed on the tendon
- Age
- Tendons become less flexible with age and more prone to damage
- Increasing age is also associated with increased risk of delayed recovery
- Gender
- May be caused by a combination of hormonal influences, biochemical variables and sporting or occupational behaviors
- Obesity
- In general, overweight or obese patients have increased risk of developing tendinopathy
- Medical conditions
- Preexisting illness such as tendon lesions or injury, anatomic and biomechanical abnormalities and comorbidities (eg arthritis, gout, cardiac disease, lipid disorders, thyroid disease and diabetes)
- Medications
- Several case reports of tendinopathy and tendon rupture commonly affecting the Achilles tendon in patients receiving fluoroquinolone treatment
- Corticosteroids can impair local collagen synthesis that can lead to tendon atrophy and reduced tensile strength
- Statins and aromatase inhibitors
- Other drugs with potential tendon toxicity include Isotretinoin, anabolic steroids and antiretroviral drugs
- Work-related factors
- Physical factors:
- Intense, repeated and sustained exertion, training errors, excessive movement and awkward posture during daily or occupational activities
- Insufficient recovery time between activities or premature return to sport
- Starting a new job or returning to work after an extended period of time away
- Poor environmental conditions (eg cold weather, running surface)
- Inadequate or poor quality equipment
- Psychosocial factors (eg monotonous work, time pressure, high work load)
- Physical factors: