Body > Tendons
Normal Age Related Tendon Changes
Mark Hurworth (Orthopedic Surgeon) and Ian Dowley (Senior Physiotherapist) discuss ‘The Anxious Tendon’ - Approaching tendinopathy treatment as a anxiety disorder of a tendon.
A tendon is like a rope – it is made up of many small fibres, and is great at transferring tension between the two ends. One end will attach to a muscle, which can generate the tension when it pulls. The other end attaches to a bone, and the tension coming through the tendon will either move or stabilise the bone.
Just like a rope, a tendon can have problems if it has too much force pulling on it, or if something is squashing it from the side. This causes pain, and is known as a tendinopathy (it used to be called tendinitis). It is often caused by repetitive or unaccustomed activities, and is most common in the part of the tendon where it attaches to the bone. The repetitive or unaccustomed load on the tendon can result in fraying, or small tears in the fibres. As we age, the microscopic structure of our tendons change, and they lose their ability to adapt quickly to new activities. Therefore, tendons are more easily irritated and can take longer to recover.
Other factors can increase the risk of tendon problems, including changes in hormones (eg. menopause, diabetes), and decreases in physical strength and fitness. As menopause can also cause inconvenient changes to the body, it is often a time when participation in exercise decreases. The hormone changes, decline in physical activity as well as the effects of aging make this a common time for women to develop tendon problems.
Commonly areas for tendinopathies include the shoulder, elbow, hip, knee and ankle.
There are many misconceptions about tendinopathies – for a long time they were thought to be inflammatory problems, so treatment mostly involved rest and anti-inflammatory medication or injections. We now understand that tendons need to be moved and worked to stay healthy, and to recover from tendinopathy. How much work is right for your tendon? Not too much, and not too little – your physiotherapist can help you find the right amount of exercise and work for your particular problem.
Further Reading
Physiotherapy management of lateral epicondylalgia
Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review