Tendinopathy

Tendinopathies affecting the upper and lower extremity are a common musculoskeletal presentation to primary care health professionals, including allied health. The etiology of tendinopathies varies depending on the area affected and the condition can affect adolescents through to older adults. However, tendinopathies are generally considered to develop when tendon is unable to adapt to a changing load environment. Tendinopathies may also be precipitated by systemic issues such as diabetes and hyperlipidemia. Knowledge of the pathophysiology of tendinopathies is continuing to emerge and this research has led to exercise being identified as one of the first-line interventions for tendinopathies. Research, particularly for lower limb tendinopathies, suggests exercise rehabilitation programs should focus on progressive loading of the tendon and include exercises that address the isometric, eccentric, and concentric phases of a muscles’ contraction. There are a variety of exercises a patient experiencing tendinopathy can utilize regardless of the tendon affected. In the early stages, most of these exercises can be performed both in the clinical setting and at the home with little to no equipment. As the exercise management progresses, equipment may be required, however. This chapter overviews the literature on the epidemiology and pathophysiology of tendinopathies. Common exercise approaches are presented for each of the upper and lower extremity tendons commonly affected. These exercises are also readily accessible to the clinician with a working knowledge of exercise prescription principles.