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Differences in Psychological Factors Between People With Persistent Tendinopathy and Those Without Tendinopathy: A
The Journal of Orthopaedic and Sports Physical Therapy
|November 27, 2025
Summary
People with tendinopathy exhibit distinct psychological profiles, including higher pain catastrophizing, depression, and anxiety, particularly in lower-limb cases. This systematic review highlights significant mental health differences compared to controls.
Area of Science:
- Orthopedics and Sports Medicine
- Psychology
- Rehabilitation Science
Background:
- Tendinopathy is a common musculoskeletal condition often associated with pain and functional limitations.
- Psychological factors are increasingly recognized as potential contributors to the development and persistence of tendinopathy.
- Understanding these psychological influences is crucial for comprehensive patient management.
Purpose of the Study:
- To systematically review and meta-analyze existing literature comparing psychological factors in individuals with and without tendinopathy.
- To identify specific psychological differences, such as pain catastrophizing, depression, anxiety, and self-efficacy, between these groups.
- To explore potential variations in psychological profiles based on the location of tendinopathy (upper vs. lower limb).
Main Methods:
- A systematic review and meta-analysis was conducted, searching seven databases until September 24, 2024.
- Studies comparing psychological factors in people with and without tendinopathy were included, excluding specific tendon injuries or systemic conditions.
- Data were synthesized using random-effects models, with subgroup analyses for upper-limb and lower-limb tendinopathy.
Main Results:
- Individuals with tendinopathy demonstrated significantly higher levels of pain catastrophizing compared to controls.
- Higher depression and anxiety scores were observed in individuals with lower-limb tendinopathy.
- No significant differences were found in kinesiophobia, general self-efficacy, extraversion, or neuroticism between groups.
Conclusions:
- People with tendinopathy present with a different psychological profile than those without the condition.
- Psychological factors, particularly pain catastrophizing, depression, and anxiety, are relevant considerations in tendinopathy management.
- Further research may elucidate the causal relationships and inform targeted psychological interventions.
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