Tendinopathy in Athletes

Tendinosis, Tendonitis, Tendinopathy... what is the correct term? This article written by Mark Reinking critically analyzes the tendon structure and it's response to exercise. 

Abstract: Overuse related tendon pain is a significant problem in sport and can interfere with and, in some instances, end an athletic career. This article includes a consideration of the biology of tendon pain including a review of tendon anatomy and histopathology, risk factors for tendon pain, semantics of tendon pathology, and the pathogenesis of tendon pain. Evidence is presented to guide the physical therapist in clinical decision-making regarding the examination of and intervention strategies for athletes with tendon pain.

Highlights:
-Human tendons demonstrate minimal hysteresis. Most stored elastic energy is released when the tensile load is removed.
-The degradation of collagen that happens after exercise is greater than the increase of collagen synthesis that occurs.
-There is an up-regulation of Vascular Endothelial Growth Factor (VEGF) in pathological tendons. VEGF factor stimulates neovascularization. This process decreases collagen strength and creates micro-tears. 
-Some new evidence supports eccentric strength training in the management of non-insertional achilles tendinopathy, patellar tendon pain, supraspinatus tendinopathy, wrist extensor tendinopathy, and posterior tibial tendinopathy (check out some of our previous posts on the topic!).  

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