Tendinopathy refers to a disease of a tendon. More specifically, it can refer to:
Tendinitis - tendon injuries that involve larger-scale acute injuries accompanied by inflammation
Tendinosis - chronic tendon injury with damage to a tendon at a cellular level
Tendon injury arise from a combination of intrinsic and extrinsic factors; acute tendon injuries may be predominantly caused by extrinsic factors, whereas in overuse syndromes as in the case of tendinopathy it may be caused by multifactorial combinations of both intrinsic and extrinsic factors. An example of an intrinsic factor for tendinopathies are: poor biomechanics such as limb malalignments and hyperpronation that may cause increased traction loads acting on the foot and ankle that may increase the incidence of Achilles, flexor hallucis longus muscle, and tibialis posterior muscle tendinopathies.
The exact etiology of tendinopathies has not been fully elucidated and different stresses may induce varying responses. There are multifactorial theories such as tensile overload, tenocyte related collagen synthesis disruption, tendon load induced ischemia, neural sprouting, thermal damage, and histological adaptive compressive responses seen as some of the causative factors that give rise to activity disruption and disability due to tendinopathies. Also, the role of environmental factors, such as diet and smoking, must not be overemphasized. The deleterious effect of smoking involve noxious effects of both nicotine, which cause vasoconstriction and decreased delivery of oxygen to tissues, and carbon monoxide, which decrease cellular oxygen tension levels. The most commonly accepted cause for this condition however is seen to be an overuse syndrome in combination with intrinsic and extrinsic factors leading to what may be seen as a progressive interference or the failing of the innate healing response.
Steroid injections are helpful in the short term (first approximately 4 weeks) however, their long term effectiveness is not known, and quality of evidence for its use remains poor and controversial. Other, more conservative and non-surgical, treatment options available for the management and treatment of tendinopathy include: rest, ice, massage therapy, eccentric exercise, NSAIDs, ultrasound therapy, LIPUS, electrotherapy, taping, sclerosing injections, blood injection, glyceryl trinitrate patches, and (ESWT) extracorporeal shockwave therapy.
^Arend CF. Ultrasound of the Shoulder. Master Medical Books, 2013. Free chapter on the role of environmental factor on the pathogenesis of rotator cuff disorders available at ShoulderUS.com