Are all tendons susceptible to chronic tendon pain?
Although all muscles have tendons, some tendons are more susceptible to developing tendon pain than others. This is commonly due to a combination of factors including the amount of work that they do, reduced blood supply to the area and anatomical factors such as a twisted pathway to their attachment site. The most common tendons that develop chronic tendon pain are the Achilles tendon at the ankle, the wrist flexors (golfer’s elbow) and extensors (tennis elbow), the rotator cuff tendons and the patellar tendon (jumper’s knee).
Why do overuse injuries happen?
It may be more correct to think about these injuries as ‘continued misuse’ injuries. Most often, overuse of the tendon in the wrong way is what actually leads to the injury. For example, if you have poor posture (slouched shoulders) and you continually reach overhead during volleyball, a tendon will be out of alignment; causing it to rub against the bone that sits above it. The repeated friction force starts the cycle of injury. This is what commonly occurs in a rotator cuff tendinopathy of the shoulder. The activity brings on the injury, but the root of the problem is improper positioning from poor posture.
Tendinopathies are also common with a sudden increase or change in load on a tendon, for example starting a new sport/activity or abruptly changing running surfaces. Use of improper equipment, for example worn out footwear or incorrect chair height in a workspace, also puts someone at risk for developing a tendon injury. Other risk factors for tendinopathies include smoking, obesity, hypertension, dyslipidemia and certain drugs like statins, flouroquinolones, and corticosteroids.
What happens to a chronically injured tendon?
When a tendon is chronically injured, some structural changes to the tissue take place. These changes lead to a disorganized, thicker, and weaker tissue that cannot withstand loading forces and continues to cause pain and swelling.
What are the symptoms of a tendinopathy?
Each person will experience symptoms differently, depending on the specifics of their injury. Most commonly people with tendinopathies experience pain and weakness with specific movements (whenever you use the injured tendon), localized pain and stiffness, and pain with increased activity.