aetiology

Last reviewed 07/2021

The aetiology of tendinopathy remains unclear and may be related to various factors.

  • stresses caused by overuse
    • repetitive overload of the tendon beyond physiological threshold may cause either inflammation of its sheath or degeneration of its body or a combination of the two (1)
    • repetitive micro trauma within the physiological limits (with little time to heal) may lead to tendinopathy
  • decreased vascularity and tensile strength with aging
  • lack of flexibility
  • muscle imbalance or weakness
  • genetic predisposition
  • endocrine disorders (1)

A variety of intrinsic and extrinsic factors have also been attributed to tendinopathy (2)

  • intrinsic factors -
    • biomechanical abnormalities of the lower extremity e.g - leg length discrepancy hyperpronation, varus deformity of the forefoot, pes cavus and limited mobility of the subtalar joint
    • increasing age
    • systemic conditions e.g. - inflammatory arthropathies, diabetes, hypertension, obesity, gout, hyperostotic conditions, lipidaemias
    • drugs e.g. - corticosteroid use,aromatase inhibitors, and quinolone antibiotics
  • extrinsic factors -  
    • excessive mechanical overload and training errors e.g.- increased interval training, abrupt changes in scheduling, excessive hill training, training on hard or sloping surfaces, increased mileage, increased repetitive loading, poor shock absorption, and wedging from uneven wear (2)

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