Management of Chronic Tendon Injuries

Area of Science:

• Orthopedics
• Sports Medicine
• Regenerative Medicine

Background:

• Tendons possess unique biological properties enabling strength and flexibility, yet are susceptible to injury.
• Chronic tendon injuries are prevalent in athletic and occupational settings, leading to numerous medical consultations.
• The term tendinopathy accurately reflects the degenerative, rather than inflammatory, nature of pathological tendons.

Purpose of the Study:

• To provide a comprehensive overview of tendinopathy, encompassing its pathology, diagnosis, and treatment.
• To differentiate tendinopathy from tendinitis, emphasizing the underlying degenerative processes.
• To discuss current and emerging treatment modalities for chronic tendon injuries.

Main Methods:

• Diagnosis relies on patient history and physical examination.
• Radiography serves as an acceptable initial imaging modality.
• Ultrasonography and magnetic resonance imaging aid in complex or unclear cases.

Main Results:

• Treatment mainstays include activity modification, relative rest, pain management, and protection.
• Early implementation of eccentric loading exercises is crucial for rehabilitation.
• Pharmacological interventions like NSAIDs and corticosteroids, alongside cryotherapy, can manage pain and improve function, despite limited evidence of inflammation.

Conclusions:

• Tendinopathy management requires a multifaceted approach, prioritizing conservative measures and targeted rehabilitation.
• While evidence varies, interventions such as topical nitroglycerin, shock wave therapy, and PRP injections offer additional nonsurgical options.
• Careful consideration of corticosteroid injections is necessary due to the risk of tendon rupture.