What is tendinopathy?

Tendinopathy is a condition that affects tendons, which are fibrous structures that connect muscles to bones. When a tendon is subjected to excessive or poorly distributed load, it can deteriorate, causing pain and loss of function. It is not just an inflammatory condition, but a degeneration of tendon tissue due to a failure in the healing mechanisms.

Anatomy and function of the tendon

Tendons are composed primarily of collagen fibers, which provide mechanical strength, and cells called tenocytes. These elements work together to allow tendons to withstand mechanical forces during movement. However, when tendons are overloaded or do not receive adequate stimulation, micro-tears can develop. If these tears do not heal properly, they can develop into tendinopathy.

Causes of tendinopathy

The main causes of tendinopathy include repetitive movements, such as those associated with sports or work, and sudden changes in activity levels. Factors such as advanced age, poor biomechanics, muscle weakness, and metabolic changes can increase the risk of developing this condition. In addition, the lack of warm-up, inadequate stretching, or periods of inactivity followed by excessive effort can compromise the integrity of the tendon.

Symptoms of tendinopathy

Patients with tendinopathy usually report pain in the affected tendon area, which worsens with physical activity. The pain may be accompanied by stiffness, especially in the morning or after long periods of inactivity. In some people, the tendon may be swollen and tender, making simple movements such as walking, climbing stairs, or lifting weights difficult.

Diagnosis

To diagnose tendinopathy, a detailed history is essential, in which the patient's symptoms and load-bearing habits are assessed. The clinical examination includes specific maneuvers to stress the tendon and determine the intensity of the pain. In some cases, ultrasound and magnetic resonance imaging can be used to confirm the diagnosis and assess the degree of tendon degeneration.

Treatment of tendinopathy

Treatment of tendinopathy is primarily conservative and involves load management and a targeted exercise plan. Initial reduction of activities that aggravate the tendon is important, but must be followed by a gradual return to exercise through a rehabilitation program. Eccentric exercises, in which the muscle is lengthened under load, are particularly effective in treating this condition. Additional therapies such as laser therapy, ultrasound, and shock waves can support tendon healing. In more severe cases or when conservative treatment fails, a surgical approach may be considered.

Prevention

Prevention of tendinopathy is mainly based on proper load management. It is essential to avoid sudden overloads and ensure gradual progression in physical activities. Proper warm-up before activity, stretching exercises and a balanced training program that includes both effort and recovery phases can help prevent the onset of this condition.

Conclusions

Tendinopathy is a complex condition that requires careful and individualized management. Conservative treatment, based on exercise and physical therapy, has been shown to be effective in most cases. However, the key to optimal management is prevention, through proper load distribution and maintenance of tendon health in the long term.