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What is Tendonopathy?

By Alex Terris
Updated Feb 01, 2024
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Tendonopathy refers to any injury or disease that affects a tendon in the body. A tendon is a strong band of tissue that connects the bones of the body to muscles and can be found in many joints including the knee and ankle. The two main types of tendonopathy are tendinitis and tendinosis. Tendinitis is an inflammatory problem in a tendon while tendinosis is a chronic condition that often occurs after the inflammation period has ended. In most cases the location of the tendonopathy defines its name so Achilles tendinitis and patellar tendinosis are two common injuries.

A healthy and normal tendon will mostly contain collagen fibers that are arranged parallel to each other. Due to the decreased blood flow in tendons compared to muscles, tendon injuries usually take much longer to heal. If injured then the tendon will normally go through three stages starting with inflammation and ending in remodeling — the process through which the tendon matures and returns to a normal state after injury.

If a tendon snaps or breaks then this is a particularly severe injury that can take a long time to heal. If a complete break in the tendon occurs then treatment can involve complex surgery to allow the tendon the best chance of repair.

Tendinitis is a common type of tendonopathy, which is usually a result of repetitive movements that put strain on a particular tendon. For example, patellar tendinitis is often caused by running due to the large amount of force transmitted with each step. Over time, micro tears in the tendon create an injury that causes pain. Tendinitis can occur anywhere there is a tendon that is put under a lot of strain although it is most common in the knee, ankle and shoulder. Treatment for tendinitis during the inflammation stage usually involves rest, icing and conservative stretching.

Tendinosis is commonly called chronic tendinitis or chronic tendonopathy. It is used to describe cellular damage to the structure of the tendon. The effects of tendinosis include similar pain to tendinitis as well as an increased risk of a full rupture of the tendon. Tendinosis is often confused for tendinitis — even among medical professionals — due to the similar symptoms. The main difference in treatment is that tendinosis will usually not respond to anti-inflammatory drugs as it is not caused by inflammation.

If a tendon suffers from some form of tendonopathy then recovery can be a long process. It is thought that in many cases a tendon will never recover its initial strength. This is because the collagen than repairs the tendon is weaker than the original collagen.

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