Tendinitis and Tendinosis/Tendinopathy Flashcards

1
Q

What is the difference between tendinitis and tendinosis/tendinopathy

A

They both are from overloading the tendon but tendinosis/tendinopathy is also degeneration of the tendon and doesn’t cause inflammation unlike tendinitis

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2
Q

what is tendinitis

A

acute condition that can cause inflammation

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3
Q

What is the treatment for tendinitis

A

rest, NSAIDS, maybe steroids (total recovery is expected)

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4
Q

what is paratendinitis

A

inflammation of the parathion (external to tendon)

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5
Q

How do you treat paratendinitis

A

the same as tendinitis

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6
Q

What is tendinosis/tendinopathy

A

Chronic condition, that doesn’t cause any inflammation, overload and degeneration of tendon

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7
Q

what is the treatment for tendinosis/tendinopathy

A

rest (possibly), NSAIDS (even though there is no inflammation)

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8
Q

Are we more likely to see tendinosis or tendinitis

A

tendinosis

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9
Q

what has a longer recovery tendinosis or tendinitis

A

tendinosis

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10
Q

What is the pathology of tendinopathy

A
  • No inflammatory cells
  • Calcification and tenderness is possible (calcific tendinopathy)
  • collagen fibers are disrupted and likely nonparallel arrangement
  • fibroblastic degeneration
  • neovascularization:
  • apoptosis:
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11
Q

What are common areas to get tendionpathy

A
  • achilles
  • posterior tip
  • patella
  • rotator cuff
  • biceps long head
  • lateral humeral condyle
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12
Q

What happens to the tendon in tendinopathy

A
  • Tendon gets thicker and is less stiff

- is very painful and produces less muscles force

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13
Q

What usually causes tendinopathy

A

overuse/overload on the tendon

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14
Q

What type of force to tendons not like

A

compresion

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15
Q

what tendon is prone to compression in the shoulder and can lead to rotator cuff pain

A

supraspinatus tendon

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16
Q

What modalities are commonly used to treat tedinopathy

A
  • ice
  • phono and iontophoresis
  • ultrasound
  • E-stim
  • laser
17
Q

Are modalities effective treatment for tendinopathy

A

no, it is unlikely that any modality is effective

18
Q

What are general treatment approaches to tendinopathy

A
  • NSAID
  • rest or controlled rest from activity
  • stretching
  • soft tissue mobilization
  • unloading/decrease load (orthotics)
  • reloading (focusing on eccentrics)
19
Q

What is the EdUReP model for tendinopathy

A

Educate
Unload
Reload
Prevent

20
Q

What way is one way to unload a tendon

A

bracing or orthotics

21
Q

What are ways we can reload the tendon

A

Eccentric exercise that gradually get loaded progressively, and within pain tolerance

22
Q

Why would we want to reload the tendon

A
  • activate tenocytes
  • remove damaged fibers
  • increase collagen synthesis
  • remodel tendon fibers
23
Q

How can we prevent tendinopathy reoccurrence

A
  • having pt complete enter eccentric prgoram
  • identify other impairments and develop interventino
  • identify comorbidiites and consult a physician
  • integrate tendon loading program for long term application
24
Q

What does evidence support as good ways to treat tendinopathy

A

eccentrics or slow resistance training

25
Q

How can we strengthen a tendon with tendinitis

A
  • compressive vs tensile load
  • emphasis on isometrics in shortened range
  • dont go below neutral
  • high load
  • progress to isotonic ex and then to eccentric
26
Q

what is an example of an eccentric exercise for achilles tendinopathy

A
  • 3x15 reps, 2x day, 7 days/week for 12 weeks

- phased eccentrics

27
Q

What are some newer approaches to tendinopathy

A
  • nitric oxide patch
  • sclerosis agents
  • stem cell
  • PRP
28
Q

Is stretching a good treatment for teninopathy

A

common treatment but not evidence for it to prevent injury