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Tendinopathy

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Tendinopathy

WHAT IS IT?

Tendons attach muscles to joint bones. As such, they transmit muscle power to the bones during movement. We use the term ‘tendinopathy’ to refer to the degenerative processes tendons can undergo, with or without inflammation.

Tendinopathy is the general term used for both tendinitis and tendinosis. While tendinitis implies inflammation of the tendon, tendinosis describes a damaged tendon due to a series of problems in the tissue of the tendon itself or the surrounding tissue.

CAUSES

The causes of tendinopathy can be varied. Tendon injuries are estimated to make up between 30% and 50% of all sports injuries. For instances, Achilles heel injuries prevail in sports that involve running.

In the world of Sports Medicine, one common cause of tendon injury is excessive muscle-building. Since the tendon is resistant and not very flexible, it can suffer as a result of repeated muscular exercise, responding to overexertion with inflammation. Excessive, poorly executed stretching can also cause tendon strain. In general, excessive demand along with microtraumas caused by repetition tend to be frequent causes of tendinous disease. 

Tendinopathy affects people who carry out repetitive tasks at work, in sport or other routine activities. Household tasks like gardening, cooking and cleaning often require repeated motions and, over time, entail the risk of developing tendinopathy.

It can occur gradually or suddenly, when the already weakened tendon undergoes a tear. The most commonly affected areas are the shoulder, elbow, wrist, hip, knee and ankle.

SYMPTOMS

The symptoms vary from one patient to the next, the most common being pain and sensitivity around the affected tendon. These symptoms can be accompanied by swelling close to the injured tendon.

Patients often experience:

  • Worsening of pain and symptoms in relation to activity.
  • Crunching, which is generally unpleasant and painful, when the tendon is used.
  • Worsening of symptoms at night and on waking up in the morning.
  • Stiffness in the affected area.
  • The presence of calcium hydroxyapatite crystals in the tendon.

The symptoms of tendinopathy are often associated with bursitis, characterised by the inflammation of the bursa.

TREATMENT

In the case of degenerative tendinous disease, conservative treatment using biological therapies will be considered, using the administration of PRGF®-Endoret® plasma rich in growth factors. This will be administered on an outpatient basis under conditions of maximum asepsis in the Biological Therapy Unit.

For the application of PRGF®-Endoret®, first of all, the focus of tendinosis will be located under ultrasound. Then, under ultrasound, recently activated PRGF®-Endoret® will be injected. In some cases, the volume to be administered may vary according to the size of the injured tendon and the degree of degeneration. It is not necessary to apply anaesthesia to the area to be treated. The application of ice after the injection is sufficient.

A follow-up ultrasound scan, carried out one or two weeks later, along with an analysis of symptoms, will establish guidelines for further application. In general, two to three PRGF®-Endoret® injections are necessary at intervals of one or two weeks.

It is advisable to accompany the local application of plasma rich in growth factors with physiotherapy, given the importance of the mechanical stimuli to induce cellular regeneration.


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