What is tendinopathy?
Tendinopathy is a condition that refers to chronic problems with tendons and includes various forms of tendon damage, such as inflammation, degenerative changes, or micro-injuries. Although it most commonly occurs in the tendons of the shoulder, elbow, knee, and ankle, tendinopathy can affect any tendon in the body.
Tendinopathy usually develops gradually, meaning it is typically the result of prolonged stress or repeated microtraumas rather than a single sudden injury. Initially, the tendon can handle the stress, but over time, structural changes occur within the tendon, which can lead to weakening, pain, and reduced functionality.
This condition includes different types of tendon injuries:
Tendinitis – Inflammation of the tendon, which may occur due to overuse or a sudden increase in physical stress.
Tendinosis – Degenerative changes within the tendon, as well as inflammation, which develop over time due to repeated stress and microtrauma, but without obvious acute inflammation.
Partial tear – Partial damage to the tendon, which can result from prolonged stress on the tendon.
Complete rupture – A complete tear of the tendon, usually as a result of very high stress or severe tendon damage.
Causes of Tendinopathy
The most common cause of tendinopathy is excessive loading of the tendon, whether through sports activities, physical labor, or repetitive movements. When a tendon is subjected to constant stress or overuse, tiny injuries occur in the tendon fibers. These microtraumas accumulate over time, leading to structural damage in the tendon, which can ultimately result in pain, inflammation, and reduced functionality. Since tendons do not have the same regenerative capacity as muscles, repeated stress can lead to a chronic condition.
The causes of excessive loading can vary:
Repetitive movements: Daily tasks or sports activities that involve repetitive motions (such as running, throwing, jumping, or lifting heavy objects) can strain the tendons. For example, tennis players, runners, swimmers, and football players are often at risk of developing tendinopathy due to the specific repetitive movements required in their activities.
Sudden increase in activity intensity: If a person engages in intense physical activities after a period of inactivity or suddenly increases the workload, it can lead to tendon injuries. For example, resuming training too quickly after a long break can cause tendon problems.
Physical labor and excessive stress: People who perform physically demanding jobs, such as lifting heavy loads or performing prolonged repetitive motions, are also prone to developing tendinopathy. Constant tendon strain causes microtraumas that can lead to more serious injuries if left untreated.
Risk Factors for Tendinopathy:
– Excessive or improper use of tendons: Although tendons can withstand a certain level of stress, improper use can lead to dysfunction. For example, poor exercise technique or performing activities more frequently than the tendon can handle may cause injuries.
– Lack of adequate rest between activities: Exercising too often without allowing enough time for recovery can lead to tendon overload. Tendons do not recover as quickly as muscles, so rest is essential for them to regenerate and function properly again.
– Poor technique or improper body posture during activities: Using poor technique when performing sports activities or physical labor increases the risk of tendon injury. For instance, lifting weights incorrectly or running with improper posture can place undue stress on the tendons, leading to injury.
– Age: As people age, tendons lose elasticity and their ability to regenerate. This makes them more prone to damage. Older individuals have a reduced capacity to handle the same stress levels that were acceptable in their younger years.
– Chronic diseases: People with chronic conditions such as diabetes or rheumatoid arthritis may be more susceptible to tendinopathy. Diabetes can negatively affect circulation and the rate of tissue healing, while rheumatoid arthritis can cause inflammation that further weakens tendons and increases the risk of injury.
Symptoms of Tendinopathy
The symptoms of tendinopathy can vary significantly depending on the severity of the injury and the stage of the condition, but they most commonly include:
Pain in the area of the affected tendon, especially during or after activity
Pain is one of the most characteristic symptoms of tendinopathy. In the early stages, pain usually appears during physical activities that involve the affected tendon and may later persist after activity and even at rest. The pain can range from mild discomfort to sharp, piercing pain that interferes with daily activities.
Swelling and a feeling of warmth around the tendon
Swelling is common in tendinopathy, especially if there is inflammation in the tendon. This swelling can be mild or pronounced and may be painful to the touch in some cases. A feeling of warmth around the tendon is a sign of an inflammatory process and may indicate an acute phase of the injury.
Decreased strength and flexibility in the affected area
As tendon damage progresses, its functionality may decrease. This means that the affected tendon loses its ability to transmit force and perform its basic functions. People with tendinopathy often notice that it becomes harder to perform the same movements as before, whether it’s lifting objects, running, or jumping. Reduced tendon flexibility can also make movement difficult, and the injured joint may have limited range of motion.
Feeling of stiffness, especially in the morning or after periods of inactivity
Stiffness is common in the morning, right after waking up, or after long periods of inactivity. The tendon may feel stiff and painful during the first movements, but as the person starts to move, the stiffness usually decreases. This stiffness is often associated with reduced blood flow or with inflammation that causes tightness in the affected tissues.
Tendinopathy can progressively worsen if left untreated, and pain and functional limitations may become more severe. Therefore, it is important to respond to early symptoms to prevent further tendon damage.
Diagnosis of Tendinopathy
Diagnosis of tendinopathy usually begins with a physical examination, during which the therapist assesses symptoms, swelling, pain, and mobility of the affected area. In some cases, X-rays or magnetic resonance imaging (MRI) may be used to gain a precise insight into the tendon damage, including the degree of inflammation, rupture, or degeneration of tendon tissue. This is especially useful in more severe cases where a detailed evaluation of the condition is required.
Treatment of Tendinopathy
Treatment of Tendinopathy at the In Locco Center is a comprehensive process that involves a combination of different therapeutic methods tailored to each patient’s needs. Our focus is on quickly reducing pain, accelerating recovery, and preventing further injuries.
Physical Therapy
Physical therapy is key for long-term recovery and prevention of future injuries. Our specialists at the In Locco Physio and Aesthetic Center provide personalized treatments individually tailored for each patient.
Shockwave Therapy – This method uses high-frequency shock waves to stimulate tendon healing and reduce pain. It is ideal for chronic tendon injuries, as it helps regenerate damaged tissue.
Laser Therapy – This therapy uses laser light to accelerate tissue regeneration, reduce inflammation, and improve circulation. It is used for both acute and chronic injuries.
Electrotherapy – This therapy uses electrical energy to help relieve pain and improve tendon function. Electrotherapy is excellent for reducing pain and swelling and stimulating faster tissue recovery.
Magnetic Therapy – Magnetic waves are used to improve circulation in affected areas and reduce inflammatory processes. It is very beneficial for patients with chronic injuries.
Ultrasound Therapy – Ultrasound waves are used to stimulate tendon healing, relieve pain, and reduce inflammation.
Kinesitherapy (Kinesiology Tape Therapy) – This therapy uses special tapes that support the tendon, reducing stress on it and improving its functionality.
Prevention of Tendinopathy – How to Avoid Injury ?
Prevention of Tendinopathy is essential for maintaining tendon health and avoiding future injuries. By focusing on proper body preparation, exercise technique, and adapting to physical activities, you can reduce the risk of developing this condition. Here are some key measures to protect your tendons:
Gradual increase in intensity and duration of physical activity
One of the most important steps in preventing tendinopathy is to gradually increase the intensity and duration of your physical activities. Sudden jumps in the volume or intensity of exercise can overload the tendons, causing microtraumas that may lead to tendinopathy.First, focus on building endurance and slowly raise the level of weights, running, or other activities to allow your body time to adjust.
The increase in workload should be gradual to avoid injuries caused by sudden stress on the tendons.
Proper warm-up before and cool-down after exercise
Warming up before physical activities prepares the tendons and muscles for increased effort, reducing injury risk. It is recommended to perform dynamic exercises that mimic the movements of the planned activity, improving blood flow and tendon flexibility.
Cooling down after exercise (including stretching and lowering intensity) helps recovery, reduces tension, and lessens future injury risks.Maintain good technique and body posture during activities
Poor technique or improper movements during physical activity increase stress on tendons, often leading to injuries.Proper biomechanics, such as correct body position during running, weightlifting, or sports exercises, can reduce unnatural pressure on tendons.
If you are unsure whether you are performing exercises correctly, consult a qualified trainer or physical therapist who can help adjust your movements and reduce risk.
Include strengthening and stretching exercises in your routine
Strengthening and stretching exercises are crucial to maintaining tendon flexibility and strength. Stronger muscles and more flexible tendons better withstand the demands of physical activity.Strengthening muscles around joints reduces pressure on tendons, making them more injury-resistant.
Stretching improves flexibility and prevents stiffness, which is particularly important for preventing injuries caused by a limited range of motion.
Wear appropriate footwear and use proper equipment
Inadequate footwear or sports equipment can increase the risk of tendon injury. For example, poorly chosen shoes can cause improper running biomechanics, adding extra stress to tendons.Choose shoes specific to your activity, whether running, hiking, or any other sport, that provide adequate support and comfort.
Always use suitable sports equipment that is in good condition and fits your needs.
Regular check-ups and expert advice
Taking time for regular physical therapy check-ups can help you recognize early symptoms of tendon problems and take appropriate preventive actions. Our expert team at In Locco Physio and Aesthetic Center offers consultations and personalized prevention plans to help you maintain tendon health and avoid injuries.