What’s Really Wrong? « Tendon Disorders: A Resource of Medical Evidence & Research

Tendon Disorders: A Resource of Medical Evidence & Research

What’s Really Wrong?

What Causes Tendon Disorders:

There are believed to be several known causes: too much stress on the tendon (either from overuse, or from a sudden change in use that traumatizes the tendon), and injury-related, disease-related or age-related changes in the tendon. Often, there is an anatomical cause for tendon disorders – some people just have a problem with the way they are built or the way they move…and that needs to be addressed. All of these conditions may be associated with a tendon’s lack of ability to properly heal itself.1

Another newly discovered cause of some tendon disorders may be fluoroquinolone antimicrobial drugs (a kind of antibiotic). The FDA recently issued a warning that fluoroquinolone antimicrobial drugs may increase the risk of tendinitis and tendon rupture.

Historical Thinking:

Historically, most health care providers and lay people have used the terms "tendonitis" or "tendinitis" to apply to all tendon disorders (painful structures in and around tendons). By definition, the suffix "itis" indicates inflammation or an active inflammatory process. With this in mind, conventional management often was, and still is, aimed at reducing or mediating the inflammatory process (rest, ice, anti-inflammatory medications, splinting/immobilization, etc.). Conventional management of tendon disorders has not been very successful. Most cases of tendinitis are resistant to treatments aimed at reducing inflammation. What is often seen with these conventional treatments is that during the treatment process the patient’s activity is usually limited and the patient may feel a little better. However, once they return to the activity, the symptoms return. This sets up a vicious cycle of taking time off from activity to decrease symptoms, followed by a return of symptoms when activity is resumed. With each recurrence of symptoms, the patient typically gets even worse and more frustrated.

Latest Research and Science:

We now know that most chronic tendon disorders are mainly degenerative (worn or broken down) in nature rather than inflammatory2. In chronic tendon disorders, there is rarely any inflammation present in the involved tendon. That is why treatments focused on trying to reduce inflammation don’t have much of an effect. The problem is that most treatments have not caught up with the latest research showing us that the cause of most tendon disorders are degeneration, or a wearing/breaking down of the tendon. We now know that in order to effectively treat tendon disorders, the focus must be on regenerating or re-healing tendons rather than on reducing inflammation.