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Tendinopathy

(Tendonitis; Tendinosis)

Definition

Tendons connect muscle to bone and help move joints. Tendinopathy is an injury to the tendon. These injuries tend to occur in tendons near joints such as the knee, shoulder, and ankle. The injuries can include:
The following tendons are often involved:
Tendonitis
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Causes

Tendinopathy is caused by overuse of a muscle-tendon unit. The strain on the tendon causes tiny tears that build up over time. There can also be inflammation.
These tears cause pain and can eventually change the structure of the tendon.

Risk Factors

Tendinopathy is more common in women than in men. It is also more common in older adults. Factors that may increase your chance of getting tendinopathy include:

Symptoms

Symptoms may include:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.
Images may be taken of the tendon and bone. This can be done with:

Treatment

Treatment depends on:
Talk with your doctor about the best treatment plan for you. Options may include:

Supportive Care

The tendon will need time to heal. Supportive care may include:
  • Restricting activities. Normal activities will be reintroduced gradually.
  • Ice therapy to help relieve swelling
  • A cast, splint, or counterforce brace to support the tendon
  • Shoe inserts or orthotics
Prescription or over-the-counter medication may be advised to reduce pain. Cortisone injections may be used if other treatments do not alleviate pain.

Physical Therapy

A physical therapist will assess the tendon. An exercise program will be created to help recovery and to strengthen the muscles.

Prevention

To prevent tendinopathy:

RESOURCES

American College of Sports Medicine http://acsm.org

FamilyDoctor—American Academy of Family Physicians http://familydoctor.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Exercise-induced leg pain. American College of Sports Medicine website. Available at: http://www.acsm.org/docs/current-comments/exercis-inducedlegpain.pdf. Accessed February 12, 2016.

Mayor RB. Treatment of athletic tendinopathy. Conn Med. 2012;76(8):471-475.

Patellar tendinopathy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 22, 2015. Accessed February 12, 2016.

Patellar tendon tear. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00512. Updated August 2009. Accessed February 12, 2016.

10/26/2010 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Massey T, Derry S, et al. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

4/24/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed March 9, 2015.

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