The tendons within the human body have the primary function of connecting muscles to parts of the body the muscles place a force on, typically bone. This clever design allows the bulky part of a muscle to be situated in an area of the body that won’t be too limiting. A great example of this is how the wrist is skinny relative to the rest of the arm as the major muscles lie further up the arm. This helps the hand access more areas while still being able to grip and produce force through the fingers. Another benefit is that the tendons also have the ability to absorb and store energy from some movements, and use this stored energy in the next movement, much like an elastic band. This makes for great efficiency in movement and allows the body to move further using less energy stores. It also means that tendon tissue does not require access to the same oxygen and nutrients as muscle tissue and so as a result, we see tendons only have a limited blood supply to them.
When tendons get injured, the tendon can respond in several different ways depending on the type and duration of the stress that caused the injury. At times there can be an inflammatory response, but this is not always the case. As a result, the type of healing reaction to the injury (inflammatory or non-inflammatory) is used to describe the injury. This is through the suffix attached to the word tendon. Often the root words that are used to construct these medical terms come from Latin or Greek origins and are used within many other pathologies. For example, the suffix “itis” is used when a condition involves an inflammatory response. Some common examples of this are; appendicitis (inflammation of the appendix), gastritis (inflammation of the lining of the gut), bronchitis (inflammation of the mucous membrane of the bronchial tubes).
Tendonitis is therefore an injury of the tendon, where the body generates an inflammatory response to try and heal the tendon. However, tendonosis is used in presentations where there is no inflammatory response, which is often the case when tendon stress has been happening for a longer period. There are also other descriptions of tendon based issues such as tenosynovitis which describes an inflammatory response to stress on a sheath that surrounds some tendons called synovium.
Tendons are therefore unique in many ways to other parts of the body in how they respond to stress or injury and how they behave. Their ability to store energy and reduced need for blood supply has great advantages. However, it also places this tissue in a position where it lacks a strong blood supply to be able to adapt to new stresses and activities. New or different activities, changes in volume, footwear, equipment, speed and surfaces, all have the potential to stress tendons more than they are accustomed to, leading to an injury.
To summarise the characteristics of a tendon in how they are injured and how they behave is challenging as there is immense complexity in their behaviour. If you need some guidance regarding a tendon issue, make a booking to see one of our physiotherapists at Malvern Physiotherapy Clinic who are very experienced in managing tendon injuries.
Published March 1, 2021
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