Tendinosis: What is it? Causes, Symptoms, Diagnosis, Therapy and Prevention
A condition other than tendonitis, tendinosis is mostly due to overuse of the suffering tendon, which makes it an example of functional overload tendinopathy.
More frequent in sportspeople, workers in strenuous work and the elderly, tendinosis mainly affects the tendons located near the large joints (eg: elbow, knee, ankle, etc.) and causes symptoms, such as pain, swelling and difficulty in movement.
For the diagnosis of tendinosis, information provided by: the patient's symptom report, physical examination, medical history and imaging tests such as ultrasound or magnetic resonance are of fundamental importance.
In general, the treatment of tendinosis involves conservative therapy, based on rest, physiotherapy and compression of the painful area; however, in some cases, it may involve the use of other treatments, including surgery.
Brief review of what "is a Tendon
A tendon is a band of fibrous connective tissue, with a certain flexibility and high in collagen, which joins a skeletal muscle to a bone., these two conditions present some substantial differences:
- While tendinosis is a suffering of a chronic nature, tendonitis is a suffering of an acute nature;
- While tendonitis is characterized by an inflammatory process affecting one or more tendons (by definition, tendonitis is the inflammation of a tendon), tendinosis is characterized by structural degeneration, without activation of the inflammatory response of the tendon or tendons involved;
- While tendinosis is related to repeated microtrauma to the affected tendon element, tendonitis is the result of a single trauma to the affected tendon;
- While those suffering from tendonitis benefit from a therapy based on non-steroidal anti-inflammatory drugs (NSAIDs), those suffering from tendinosis tend not to benefit from the use of NSAIDs (indeed, it seems that, in some cases, NSAIDs slow down the healing process).
- Tendinosis is a chronic suffering: it means that it is a long-lasting condition and for which several months of therapy are required.
- Tendinosis is characterized by a degeneration of the normal tendon structure: it means that the suffering tendon is the victim of a "tissue alteration, which causes injury, thickening, hardening with loss of elasticity and / or scarring. .
Most Common Locations of Tendinosis
Any tendon in the human body can be a victim of tendinosis; however, statistics in hand, the tendons that suffer most from this chronic tendinopathy are those having relationships with important joints, such as elbow, shoulder, knee, ankle and hip, and the so-called Achilles tendon.
Tendinosis is most common among tendons located near important joints, such as the elbow, shoulder, knee, ankle, hip, and the Achilles tendon.physicists that produce a tendon injury.
How Can Excessive Use of a Tendon Lead to Tendinosis?
The expression "excessive use of a tendon" refers to the situation in which there is a continuous motor stimulation of the tendon in question, for the purpose of precise movement of the body.
The excessive use of a tendon is associated with tendinosis, because it is responsible for series microtraumas which, in the long term, produce the degeneration of the tendon structure.
Overuse tendinosis, therefore, is the result of repeated small stresses on a tendon, which, in the long run, end up undermining the integrity of the tendon structure.
An example of functional overload tendinopathy, overuse tendinosis most frequently affects the tendons located near the large joints (e.g. elbow), as they are the ones most involved in the movement of the body.
Risk Factors: Who Suffers Most from Tendinosis?
To suffer most from tendinosis are:
- People who play sports on a daily basis and athletes.
Because? Practicing sports involves moving the muscles with their tendons and taking advantage of the mobility of the joints; clearly, the more intense the sport, the more likely it is to incur some injury from overuse of a muscle, tendon and / or joint.
To minimize the risk of injury, those who train constantly should: set rest periods to be respected; do not exceed in daily physical activity with the hope of obtaining better results; increase the intensity of exercise gradually; rely on or at least seek advice from a person specialized in the sport of interest; lead a healthy lifestyle.
- Individuals who practice jobs or hobbies that are particularly physically demanding.
Because? The so-called manual jobs, as well as the hobbies that require a certain physical stress, involve the sometimes excessive use of the muscles with their tendons and joints.
Because? Aging involves a reduction in the flexibility of the muscles and adjoining tendons, and a loss of mobility on the part of the joints; less flexible muscles and tendons, and less mobile joints favor the onset of diseases of the musculoskeletal system, including tendinosis.
- People with some form of arthritis.
Because? Statistics show that arthritis sufferers tend to develop tendinosis more frequently.
Most important types of Tendinosis
Among the most important and frequent tendinoses, the following deserve a mention: lateral epicondylitis (also known as tennis elbow), patellar tendinosis (also known as jumper's knee) and Achilles tendinosis (also known as tendinosis). yarrow).
LATERAL EPICONDYLITIS (OR TENNIS ELBOW)
Tennis elbow is the tendinosis affecting the tendons that connect the muscles of the forearm to the external part of the elbow (to be precise, to the lateral epicondyle of the humerus).
To suffer most from tennis elbow are:
- Sports practitioners in which the use of a racket is required (eg tennis, badminton or squash);
- Practitioners of throwing sports (eg javelin or discus throwing);
- Sports practitioners such as golf and fencing;
- People who practice a profession that involves repetitive movements of the elbow-wrist-hand complex (eg: bricklayers, plumbers, carpenters, butchers, cooks or carpenters);
- Individuals who play musical instruments for which the use of the lower limbs is necessary (eg violinists).
ROTULA TENDINOSIS (JUMPER'S KNEE)
The jumper's knee is the tendinosis of the patellar tendon, which is the tendon that connects the patella of the knee to the tibial tuberosity of the tibia (one of the two bones of the leg).
The tendinosis of the patellar tendon mainly affects sportsmen, in particular those who practice sports in which the gesture of jumping is frequently foreseen (eg: volleyball, athletics, basketball or football).
TENDINOSI AL TENDINE D "ACHILLEA (OR TENDINOSI ACHILLEA)
Achilles tendinosis is the tendinosis of the Achilles tendon, which is the tendon that connects the calf muscles to the back bone of the foot known as the calcaneus.
Achilles tendonosis mainly affects:
- Those who practice sports;
- Who has the habit of wearing shoes inadequate to the anatomy and physiology of the foot;
- People with rheumatoid arthritis.
When to see a doctor?
Tendinosis are conditions for which it is advisable to consult a doctor with expertise in the field as soon as possible.
To know when to contact a doctor, it is essential to evaluate the pain, which, in case of tendinosis, is constant and persistent despite the rest from any activity potentially harmful to the suffering tendon.
What to do if the Conservative Treatment is ineffective?
If conservative treatment of tendinosis is ineffective, doctors can draw on more invasive or less conventional treatments, such as:
- Surgery to repair damaged tendons. Surgery is especially helpful in the presence of severe tendinosis. Of the therapies proposed here as an alternative to conservative treatment, it is certainly the most valid and effective;
- The "injection of corticosteroids in a point adjacent to the damaged tendon. It is a" therapeutic option that raises strong discussions among professionals and increasingly in disuse, as in some situations it proves more harmful than beneficial (it seems that it slows down the production collagen, the fundamental protein of the tendons);
- The injection of platelet-rich plasma into an area adjacent to the damaged tendon. According to some studies, this remedy would aid in the repair and healing of damaged tendon tissue.
Tendinosis does not benefit from anti-inflammatory treatments (eg: NSAIDs or ice packs), since, unlike tendonitis, it is not supported by inflammatory processes.and the variation of training.