Tendons are there to transfer the force of a muscle to a bone. They are made of special fibrous tissues that contain collagen fibers. Compared to other tissues in the body, their blood supply is poor. For the most part, it is supplied passively through vessels from muscles, bones and tendon sheaths. Tendons have few cells that divide slowly. In the process, they renew the tissue – or repair damage such as injuries. Because of metabolism, tendon injuries take longer to heal. Below, we provide an overview of possible tendon injuries and basic information on how to treat them.
Causes of tendon injuries
Tendon injuries can occur in a number of ways.
Poor warm-up and stretching
Inadequate warm-up and stretching before exercise can make tendons less flexible and increase the risk of injury.
Tendon injuries are often the result of chronic overuse. Repeated, intense stress on the tendons, without adequate rest and recovery, can lead to microtears. This often occurs in sports that require repetitive movements such as running, tennis, golf or baseball.
Acute injuries, such as sudden impacts or falls, can lead to tendon tears. For example, a fall on the extended leg can lead to an Achilles tendon tear.
Incorrect posture and inadequate technique
Incorrect posture or inadequate technique during certain activities can place excessive stress on tendons. This is often the case with weight training or sports involving explosive movements. These are fast and powerful activities in which the muscles release a high amount of energy in a short period of time to produce maximum power. These are for example jumps, sprints and throws.
As we age, the elasticity and strength of tendons decreases, increasing the risk of tendon injury. This is a natural process and can lead to injury.
Some individuals have a higher risk of tendon injury due to their anatomical structure. For example, an abnormal tendon path can increase the risk.
Medications and diseases
Certain medications, such as fluoroquinolones, can make tendons more unstable, making you more likely to injure them. In addition, diseases such as rheumatism or diabetes can make tendons more vulnerable.
Inflammation, tear and strain: the most common tendon injuries
Tendon inflammation (tendinitis)
So-called tendinitis is an inflammation of a tendon. In this case, it is irritated and swollen. This causes pain that usually occurs near the affected tendon. The pain often intensifies with movement or strain on the affected region, with limited functionality. The affected region may feel stiff, especially in the morning or after prolonged rest. In some cases, the skin over the affected tendon may also be red and warmer than the surrounding skin.
The cause is usually overuse, e.g. due to repetitive movements, incorrect technique in sports or unfavorable workplace conditions.
Typical examples of tendonitis are Achilles tendonitis and tennis or golfer’s elbow.
Another possible tendon injury is a strain. It occurs when a tendon is stretched beyond its normal extent. Again, there may be pain, swelling, redness and sometimes bruising at the affected area. The severity of the stretch can vary from mild to severe.
Tendon strain can occur when a tendon is abruptly or excessively stretched, for example, by a sudden impact, a strong tensile load, or a rapid movement. Repetitive motions or stresses that strain a tendon over a long period of time can also cause it. This often occurs in sports or occupational activities that require repetitive motion. If you do not warm up or stretch adequately before exercising or doing physical work, this can increase your risk for a pulled tendon.
A typical example is the strain of the tendons in the thigh area (quadriceps tendon strain).
When a tendon partially or completely ruptures, it is called tendinosis. Tendon rupture is usually accompanied by severe, sudden pain near the injured tendon. The pain can be so severe that it significantly restricts movement of the affected area. In addition, there is swelling. Since the small blood vessels near the torn tendon are usually damaged as well, there is also a bruise in most cases.
A tendon rupture can significantly affect the normal function of the muscle associated with the torn tendon. This often leads to a noticeable loss of strength as well as a restriction of movement.
The causes are, for example, accidents or overuse of the tendon. Degenerative changes, as can occur through the natural aging process, or congenital malpositions are also often to blame for ruptures. Tendon ruptures are also common sports accidents or the result of improper technique during training.
Typical examples are the rupture of the biceps tendon or the patellar tendon.
You can also read more about this topic here: Tendon rupture: What happens when a tendon tears?
Other types of tendon problems
In addition to the typical tendon injuries mentioned above, there are other problems that can affect tendons. For example, various other conditions can also be associated with pain, dysfunction and limited movement:
In a condition called tendovaginitis, the tendon sheath (e.g., in the elbow), a protective tube that surrounds and lubricates the tendon, becomes inflamed.
This is a problem in which the tendon does not slide smoothly in its tendon sheath. This is referred to as tendosynovitis. The wrists are often affected here.
This is a condition in which calcium deposits occur in the tendon. Tendinosis calcarea often occurs in the shoulder (calcareous shoulder).
Sometimes a tendon can slip or slide out of its normal position. This can cause it to shift. This is called tendon dislocation. An example is flexor tendon luxation in the fingers.
Tendon tissue thickening
In this condition, the tissue of the tendon thickens abnormally, for example, at the knee.
Diagnostics and therapy for tendon injuries in Frankfurt
It is important to take tendon injuries seriously and seek medical attention to ensure the best possible recovery.
If you have had an accident or suddenly notice pain, limited range of motion or other problems that may indicate tendon injuries and disorders listed above, please make an appointment with our private practice for orthopedics and traumatology in Frankfurt.
We specialize in the diagnosis and treatment of a wide variety of injuries. In addition, we are also experts in the field of sports medicine and sports injuries. To find out what exactly is wrong with you, we work with a modern, high-resolution ultrasound machine as well as a fully digital X-ray machine.
The particular treatment depends on the type and severity of your individual tendon problem. Therapy may include immobilization with bandages and orthotics, physical therapy, anti-inflammatory medications and targeted exercises to strengthen the muscles around the affected tendon. Peri- and intra-articular infiltrations, PRP treatment, shock wave therapy, acupuncture or kinesio-taping in our practice in Frankfurt are also possible.
In severe cases, surgery may be necessary.
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