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class="vector-toc-numb">2</span> <span>Cause</span> </div> </a> <button aria-controls="toc-Cause-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Cause subsection</span> </button> <ul id="toc-Cause-sublist" class="vector-toc-list"> <li id="toc-Types" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Types"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Types</span> </div> </a> <ul id="toc-Types-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pathophysiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Pathophysiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Pathophysiology</span> </div> </a> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> </ul> </li> <li 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class="vector-toc-list"> </ul> </li> <li id="toc-Other_injections" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_injections"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.3</span> <span>Other injections</span> </div> </a> <ul id="toc-Other_injections-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Terminology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Terminology"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Terminology</span> </div> </a> <ul id="toc-Terminology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Research</span> </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_animals" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Other_animals"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Other animals</span> </div> </a> <ul id="toc-Other_animals-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" 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Available in 18 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-18" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">18 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D9%84%D8%AA%D9%87%D8%A7%D8%A8_%D8%A7%D9%84%D8%A3%D9%88%D8%AA%D8%A7%D8%B1" title="التهاب الأوتار – Arabic" lang="ar" hreflang="ar" data-title="التهاب الأوتار" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Tendinopatia" title="Tendinopatia – Catalan" lang="ca" hreflang="ca" data-title="Tendinopatia" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Tendopathie" title="Tendopathie – German" lang="de" hreflang="de" data-title="Tendopathie" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%A4%CE%B5%CE%BD%CE%BF%CE%BD%CF%84%CE%BF%CF%80%CE%AC%CE%B8%CE%B5%CE%B9%CE%B1" title="Τενοντοπάθεια – Greek" lang="el" hreflang="el" data-title="Τενοντοπάθεια" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Tendinopat%C3%ADa" title="Tendinopatía – Spanish" lang="es" hreflang="es" data-title="Tendinopatía" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%9F%E0%A5%87%E0%A4%82%E0%A4%A1%E0%A4%BF%E0%A4%A8%E0%A5%8B%E0%A4%AA%E0%A5%88%E0%A4%A5%E0%A5%80" title="टेंडिनोपैथी – Hindi" lang="hi" hreflang="hi" data-title="टेंडिनोपैथी" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Tendinopatia" title="Tendinopatia – Italian" lang="it" hreflang="it" data-title="Tendinopatia" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%93%D7%9C%D7%A7%D7%AA_%D7%92%D7%99%D7%93%D7%99%D7%9D" title="דלקת גידים – Hebrew" lang="he" hreflang="he" data-title="דלקת גידים" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Tendinitas" title="Tendinitas – Lithuanian" lang="lt" hreflang="lt" data-title="Tendinitas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Tendinopati" title="Tendinopati – Malay" lang="ms" hreflang="ms" data-title="Tendinopati" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%85%B1%E9%9A%9C%E5%AE%B3" title="腱障害 – Japanese" lang="ja" hreflang="ja" data-title="腱障害" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%9F%E0%AD%87%E0%AC%A3%E0%AD%8D%E0%AC%A1%E0%AC%BF%E0%AC%A8%E0%AD%8B%E0%AC%AA%E0%AC%BE%E0%AC%A5%E0%AC%BF" title="ଟେଣ୍ଡିନୋପାଥି – Odia" lang="or" hreflang="or" data-title="ଟେଣ୍ଡିନୋପାଥି" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Bilak_tendovaginiti" title="Bilak tendovaginiti – Uzbek" lang="uz" hreflang="uz" data-title="Bilak tendovaginiti" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Tendinopatia" title="Tendinopatia – Portuguese" lang="pt" hreflang="pt" data-title="Tendinopatia" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A2%D0%B5%D0%BD%D0%B4%D0%B8%D0%BD%D0%BE%D0%B7" title="Тендиноз – Russian" lang="ru" hreflang="ru" data-title="Тендиноз" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Tendinopati" title="Tendinopati – Swedish" lang="sv" hreflang="sv" data-title="Tendinopati" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/Tendinopathy" title="Tendinopathy – Thai" lang="th" hreflang="th" data-title="Tendinopathy" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%82%8C%E8%85%B1%E7%97%85%E8%AE%8A" title="肌腱病變 – Chinese" lang="zh" hreflang="zh" data-title="肌腱病變" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q1682583#sitelinks-wikipedia" title="Edit interlanguage 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id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Inflammation of the tendon</div> <p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Tenonitis" title="Tenonitis">Tenonitis</a> or <a href="/wiki/Tenosynovitis" title="Tenosynovitis">Tenosynovitis</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Tendinopathy</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">tendinosus<sup id="cite_ref-AFP2005_1-0" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span typeof="mw:File"><a href="/wiki/File:Achilles-tendon.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Achilles-tendon.jpg/200px-Achilles-tendon.jpg" decoding="async" width="200" height="339" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/3/3c/Achilles-tendon.jpg 1.5x" data-file-width="280" data-file-height="474" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Achilles_tendon" title="Achilles tendon">Achilles tendon</a> (a commonly affected tendon)</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data">Primary care</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Pain, swelling<sup id="cite_ref-NIH2017_2-0" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Injury from repetitive activities, overuse<sup id="cite_ref-NIH2017_2-1" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Based on symptoms, <a href="/wiki/Physical_exam" class="mw-redirect" title="Physical exam">examination</a>, <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a><sup id="cite_ref-NIH2017Diag_3-0" class="reference"><a href="#cite_note-NIH2017Diag-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Rest, <a href="/wiki/NSAIDs" class="mw-redirect" title="NSAIDs">NSAIDs</a>, splinting, <a href="/wiki/Physiotherapy" class="mw-redirect" title="Physiotherapy">physiotherapy</a><sup id="cite_ref-NIH2017_2-2" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">80% better within 6 months for overuse tendinopathy<sup id="cite_ref-AFP2005_1-1" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">Common<sup id="cite_ref-AFP2005_1-2" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NIH2017_2-3" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr></tbody></table> <p><b>Tendinopathy</b> is a type of <a href="/wiki/Tendon" title="Tendon">tendon</a> disorder that results in pain, swelling, and impaired function.<sup id="cite_ref-NIH2017_2-4" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The pain is typically worse with movement.<sup id="cite_ref-NIH2017_2-5" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> It most commonly occurs around the shoulder (<a href="/wiki/Rotator_cuff_tendinitis" class="mw-redirect" title="Rotator cuff tendinitis">rotator cuff tendinitis</a>, <a href="/wiki/Biceps_tendinitis" class="mw-redirect" title="Biceps tendinitis">biceps tendinitis</a>), elbow (<a href="/wiki/Tennis_elbow" title="Tennis elbow">tennis elbow</a>, <a href="/wiki/Golfer%27s_elbow" title="Golfer's elbow">golfer's elbow</a>), wrist, hip, knee (<a href="/wiki/Jumper%27s_knee" class="mw-redirect" title="Jumper's knee">jumper's knee</a>, popliteus tendinopathy), or ankle (<a href="/wiki/Achilles_tendinitis" title="Achilles tendinitis">Achilles tendinitis</a>).<sup id="cite_ref-AFP2005_1-3" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NIH2017_2-6" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Causes may include an injury or repetitive activities.<sup id="cite_ref-NIH2017_2-7" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Less common causes include <a href="/wiki/Infection" title="Infection">infection</a>, <a href="/wiki/Arthritis" title="Arthritis">arthritis</a>, <a href="/wiki/Gout" title="Gout">gout</a>, <a href="/wiki/Thyroid_disease" title="Thyroid disease">thyroid disease</a>, <a href="/wiki/Diabetes" title="Diabetes">diabetes</a> and the use of <a href="/wiki/Quinolone_antibiotic" title="Quinolone antibiotic">quinolone antibiotic</a> medicines.<sup id="cite_ref-BMJ2002_4-0" class="reference"><a href="#cite_note-BMJ2002-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NIH2017Cau_5-0" class="reference"><a href="#cite_note-NIH2017Cau-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Groups at risk include people who do manual labor, musicians, and athletes.<sup id="cite_ref-NIH2017_2-8" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Diagnosis is typically based on symptoms, <a href="/wiki/Physical_exam" class="mw-redirect" title="Physical exam">examination</a>, and occasionally <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a>.<sup id="cite_ref-NIH2017Diag_3-1" class="reference"><a href="#cite_note-NIH2017Diag-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> A few weeks following an injury little <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> remains, with the underlying problem related to weak or disrupted tendon <a href="/wiki/Fibrils" class="mw-redirect" title="Fibrils">fibrils</a>.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p><p>Treatment may include rest, <a href="/wiki/NSAIDs" class="mw-redirect" title="NSAIDs">NSAIDs</a>, splinting, and <a href="/wiki/Physiotherapy" class="mw-redirect" title="Physiotherapy">physiotherapy</a>.<sup id="cite_ref-NIH2017_2-9" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Less commonly <a href="/wiki/Steroid_injections" class="mw-redirect" title="Steroid injections">steroid injections</a> or surgery may be done.<sup id="cite_ref-NIH2017_2-10" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> About 80% of overuse tendinopathy patients recover completely within six months.<sup id="cite_ref-AFP2005_1-4" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Tendinopathy is relatively common.<sup id="cite_ref-NIH2017_2-11" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Older people are more commonly affected.<sup id="cite_ref-NIH2017_2-12" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> It results in a large amount of missed work.<sup id="cite_ref-AFP2005_1-5" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Symptoms include tenderness on palpation, swelling, and <a href="/wiki/Pain" title="Pain">pain</a>, often when exercising or with a specific movement.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=2" title="Edit section: Cause"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Causes may include an injury or repetitive activities.<sup id="cite_ref-NIH2017_2-13" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Groups at risk include people who do manual labor, musicians, and athletes.<sup id="cite_ref-NIH2017_2-14" class="reference"><a href="#cite_note-NIH2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Less common causes include <a href="/wiki/Infection" title="Infection">infection</a>, <a href="/wiki/Arthritis" title="Arthritis">arthritis</a>, <a href="/wiki/Gout" title="Gout">gout</a>, <a href="/wiki/Thyroid_disease" title="Thyroid disease">thyroid disease</a>, and <a href="/wiki/Diabetes" title="Diabetes">diabetes</a>.<sup id="cite_ref-NIH2017Cau_5-1" class="reference"><a href="#cite_note-NIH2017Cau-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Successful treatments include rehabilitation therapy and/or surgery.<sup id="cite_ref-pmid15116648_8-0" class="reference"><a href="#cite_note-pmid15116648-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Obesity" title="Obesity">Obesity</a>, or more specifically, <a href="/wiki/Adiposity" class="mw-redirect" title="Adiposity">adiposity</a> or fatness, has also been linked to an increasing incidence of tendinopathy.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Quinolone_antibiotic" title="Quinolone antibiotic">Quinolone antibiotics</a> are associated with increased risk of tendinitis and tendon rupture.<sup id="cite_ref-FDA2016_10-0" class="reference"><a href="#cite_note-FDA2016-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> A 2013 review found the incidence of tendon injury among those taking fluoroquinolones to be between 0.08 and 0.2%.<sup id="cite_ref-QuinTendon2013_11-0" class="reference"><a href="#cite_note-QuinTendon2013-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Fluoroquinolones most frequently affect large load-bearing tendons in the lower limb, especially the Achilles tendon which ruptures in approximately 30 to 40% of cases.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Types">Types</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=3" title="Edit section: Types"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Achilles_tendinitis" title="Achilles tendinitis">Achilles tendinitis</a></li> <li><a href="/wiki/Calcific_tendinitis" title="Calcific tendinitis">Calcific tendinitis</a></li> <li><a href="/wiki/Patellar_tendinitis" title="Patellar tendinitis">Patellar tendinitis</a> (jumper's knee)</li></ul> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=4" title="Edit section: Pathophysiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As of 2016, the <a href="/wiki/Pathophysiology" title="Pathophysiology">pathophysiology</a> of tendinopathy is poorly understood. While <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> appears to play a role, the relationships among changes to the structure of tissue, the function of tendons, and pain are not understood and there are several competing models, none of which have been fully validated or falsified.<sup id="cite_ref-Millar_13-0" class="reference"><a href="#cite_note-Millar-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Molecular mechanisms involved in inflammation includes release of inflammatory cytokines like IL-1β which reduces the expression of type I collagen mRNA in human <a href="/wiki/Tenocyte" class="mw-redirect" title="Tenocyte">tenocytes</a> and causes extracellular matrix degradation in the tendon.<sup id="cite_ref-Millar_13-1" class="reference"><a href="#cite_note-Millar-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> In a 2020 systematic review, it was noted that while various inflammatory markers were present in two thirds of the reviewed articles, the heterogenicity of data and lack of comparable studies meant no conclusion about a common pathophysiology from this systematic review.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p>There are multifactorial theories that could include: tensile overload, tenocyte related collagen synthesis disruption, load-induced ischemia, neural sprouting, thermal damage, and adaptive compressive responses. The intratendinous sliding motion of fascicles and shear force at interfaces of fascicles could be an important mechanical factor for the development of tendinopathy and predispose tendons to rupture.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p><p>The most commonly accepted cause for this condition is seen to be an overuse syndrome in combination with intrinsic and extrinsic factors leading to what may be seen as a progressive interference or the failing of the innate healing response. Tendinopathy involves cellular apoptosis, matrix disorganization and neovascularization.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>Classic characteristics of "tendinosis" include degenerative changes in the collagenous matrix, hypercellularity, hypervascularity, and a lack of inflammatory cells which has challenged the original misnomer "tendinitis".<sup id="cite_ref-pmid21144004_18-0" class="reference"><a href="#cite_note-pmid21144004-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid19591655_19-0" class="reference"><a href="#cite_note-pmid19591655-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p>For chronic tennis elbow, histological findings include granulation tissue, microrupture, degenerative changes, and there is no traditional inflammation. As a consequence, "lateral elbow tendinopathy or tendinosis" is used instead of "<a href="/wiki/Lateral_epicondylitis" class="mw-redirect" title="Lateral epicondylitis">lateral epicondylitis</a>".<sup id="cite_ref-du_ToitStieler2008_20-0" class="reference"><a href="#cite_note-du_ToitStieler2008-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> Examination of pathologic tennis elbow tissue reveals noninflammatory tissue, so the term "angiofibroblastic tendinosis" is also used.<sup id="cite_ref-pmid1423702_21-0" class="reference"><a href="#cite_note-pmid1423702-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p><p>Cultures from tendinopathic tendons contain an increased production of <a href="/wiki/Type_III_collagen" class="mw-redirect" title="Type III collagen">type III collagen</a>.<sup id="cite_ref-pmid10921640_22-0" class="reference"><a href="#cite_note-pmid10921640-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid25383170_23-0" class="reference"><a href="#cite_note-pmid25383170-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p><p>Longitudinal sonogram of the lateral elbow displays thickening and heterogeneity of the common extensor tendon that is consistent with tendinosis, as the ultrasound reveals calcifications, intrasubstance tears, and marked irregularity of the lateral epicondyle. Although the term "epicondylitis" is frequently used to describe this disorder, most histopathologic findings of studies have displayed no evidence of an acute, or a chronic inflammatory process. Histologic studies have demonstrated that this condition is the result of tendon degeneration, which causes normal tissue to be replaced by a disorganized arrangement of collagen. Therefore, the disorder is more appropriately referred to as "tendinosis" or "tendinopathy" rather than "tendinitis".<sup id="cite_ref-pmid16998100_24-0" class="reference"><a href="#cite_note-pmid16998100-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p><p>Colour Doppler ultrasound reveals structural tendon changes, with vascularity and hypo-echoic areas that correspond to the areas of pain in the extensor origin.<sup id="cite_ref-ZeisigÖhberg2006_25-0" class="reference"><a href="#cite_note-ZeisigÖhberg2006-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p><p>Load-induced non-rupture tendinopathy in humans is associated with an increase in the ratio of collagen III:I proteins, a shift from large to small diameter collagen fibrils, buckling of the collagen fascicles in the tendon extracellular matrix, and buckling of the tenocyte cells and their nuclei.<sup id="cite_ref-pmid24571576_26-0" class="reference"><a href="#cite_note-pmid24571576-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=5" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Tendonitis_Tendon_rupture_--_Smart-Servier_(cropped).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/80/Tendonitis_Tendon_rupture_--_Smart-Servier_%28cropped%29.jpg/300px-Tendonitis_Tendon_rupture_--_Smart-Servier_%28cropped%29.jpg" decoding="async" width="300" height="169" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/80/Tendonitis_Tendon_rupture_--_Smart-Servier_%28cropped%29.jpg/450px-Tendonitis_Tendon_rupture_--_Smart-Servier_%28cropped%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/80/Tendonitis_Tendon_rupture_--_Smart-Servier_%28cropped%29.jpg/600px-Tendonitis_Tendon_rupture_--_Smart-Servier_%28cropped%29.jpg 2x" data-file-width="8192" data-file-height="4608" /></a><figcaption>Diagram illustrating tendonitis and tendon rupture</figcaption></figure> <p>Symptoms can vary from aches or pains and local <a href="/wiki/Joint_stiffness" title="Joint stiffness">joint stiffness</a>, to a burning that surrounds the whole <a href="/wiki/Joint" title="Joint">joint</a> around the inflamed tendon. In some cases, swelling occurs along with heat and redness, and there may be visible knots surrounding the joint. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiff the following day as muscles tighten from the movement of the tendon. Many patients report stressful situations in their life in correlation with the beginnings of pain which may contribute to the symptoms.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (October 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Medical_imaging">Medical imaging</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=6" title="Edit section: Medical imaging"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ultrasound imaging can be used to evaluate tissue strain, as well as other mechanical properties.<sup id="cite_ref-pmid21030024_27-0" class="reference"><a href="#cite_note-pmid21030024-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Ultrasound-based techniques are becoming more popular because of its affordability, safety, and speed. Ultrasound can be used for imaging tissues, and the sound waves can also provide information about the mechanical state of the tissue.<sup id="cite_ref-pmid22542220_28-0" class="reference"><a href="#cite_note-pmid22542220-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=7" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Treatment of tendon injuries is largely conservative. Use of <a href="/wiki/Non-steroidal_anti-inflammatory_drug" class="mw-redirect" title="Non-steroidal anti-inflammatory drug">non-steroidal anti-inflammatory drugs</a> (NSAIDs), rest, and gradual return to exercise is a common therapy. A meta-analysis revealed that exercise using weights or a resistance band is more effective than using bodyweight alone. In addition, having rest days is more effective than exercising every day.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Resting assists in the prevention of further damage to the tendon. Ice, compression and elevation are also frequently recommended. <a href="/wiki/Physical_therapy" title="Physical therapy">Physical therapy</a>, <a href="/wiki/Occupational_therapy" title="Occupational therapy">occupational therapy</a>, orthotics or braces may also be useful. Initial recovery is typically within two to three days and full recovery is within three to six months.<sup id="cite_ref-AFP2005_1-6" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Tendinosis occurs as the acute phase of healing has ended (six to eight weeks) but has left the area insufficiently healed. Treatment of tendinitis helps reduce some of the risks of developing tendinosis, which takes longer to heal.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (October 2020)">citation needed</span></a></i>]</sup> </p><p>There is tentative evidence that <a href="/wiki/Low-level_laser_therapy" title="Low-level laser therapy">low-level laser therapy</a> may also be beneficial in treating tendinopathy.<sup id="cite_ref-pmid19708800_31-0" class="reference"><a href="#cite_note-pmid19708800-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> The effects of deep transverse friction massage for treating tennis elbow and lateral knee tendinitis is unclear.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="NSAIDs">NSAIDs</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=8" title="Edit section: NSAIDs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>NSAIDs may be used to help with pain.<sup id="cite_ref-AFP2005_1-7" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> They however do not alter long term outcomes.<sup id="cite_ref-AFP2005_1-8" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Other types of pain medication, like <a href="/wiki/Paracetamol" title="Paracetamol">paracetamol (acetaminophen)</a>, may be just as useful.<sup id="cite_ref-AFP2005_1-9" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Steroids">Steroids</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=9" title="Edit section: Steroids"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Steroid injections have not been shown to have long term benefits for tendonitis, but appear to improve pain and function in the short term more effectively than other treatments except NSAIDs.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> They appear to have little benefit in tendinitis of the rotator cuff.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> There are some concerns that they may have negative effects.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Other_injections">Other injections</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=10" title="Edit section: Other injections"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There is insufficient evidence on the routine use of injection therapies (autologous blood, platelet-rich plasma, deproteinised haemodialysate, aprotinin, polysulphated <a href="/wiki/Glycosaminoglycan" title="Glycosaminoglycan">glycosaminoglycan</a>, skin derived fibroblasts etc.) for treating Achilles tendinopathy.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> As of 2014 there was insufficient evidence to support the use of platelet-rich therapies for treating musculoskeletal soft tissue injuries such as ligament, muscle and tendon tears and tendinopathies.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=11" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Initial recovery from overuse tendinosus is usually within two to three months, and 80% will recover fully within three to six months.<sup id="cite_ref-AFP2005_1-10" class="reference"><a href="#cite_note-AFP2005-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=12" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Tendon" title="Tendon">Tendon</a> injury and resulting tendinopathy are responsible for up to 30% of consultations to sports doctors and other musculoskeletal health providers.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Tendinopathy is most often seen in tendons of athletes either before or after an injury but is becoming more common in non-athletes and sedentary populations. For example, the majority of patients with Achilles tendinopathy in a general population-based study did not associate their condition with a sporting activity.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> In another study the population incidence of Achilles tendinopathy increased sixfold from 1979–1986 to 1987–1994.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> The incidence of rotator cuff tendinopathy ranges from 0.3% to 5.5% and annual prevalence from 0.5% to 7.4%.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Terminology">Terminology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=13" title="Edit section: Terminology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Tendinitis is a very common, but misleading term. By definition, the suffix "-itis" means "inflammation of". Inflammation<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> is the body's local response to tissue damage which involves red blood cells, white blood cells, blood proteins with dilation of blood vessels around the site of injury. Tendons are relatively avascular.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> Corticosteroids are drugs that reduce inflammation. Corticosteroids can be useful to relieve chronic tendinopathy pain, improve function, and reduce swelling in the short term. However, there is a greater risk of long-term recurrence.<sup id="cite_ref-ReesStride2013_44-0" class="reference"><a href="#cite_note-ReesStride2013-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> They are typically injected along with a small amount of a numbing drug called lidocaine. Research shows that tendons are weaker following corticosteroid injections. </p><p>Tendinitis is still a very common diagnosis, though research increasingly documents that what is thought to be tendinitis is usually tendinosis.<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p><p>Anatomically close but separate conditions are: </p> <ul><li><a href="/wiki/Enthesitis" title="Enthesitis">Enthesitis</a>, wherein there is inflammation of the <a href="/wiki/Entheses" class="mw-redirect" title="Entheses">entheses</a>, the sites where tendons or ligaments insert into the bone.<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> It is associated with <a href="/wiki/HLA_B27" class="mw-redirect" title="HLA B27">HLA B27</a> arthropathies such as <a href="/wiki/Ankylosing_spondylitis" title="Ankylosing spondylitis">ankylosing spondylitis</a>, <a href="/wiki/Psoriatic_arthritis" title="Psoriatic arthritis">psoriatic arthritis</a>, and <a href="/wiki/Reactive_arthritis" title="Reactive arthritis">reactive arthritis</a>.<sup id="cite_ref-Schett2017_48-0" class="reference"><a href="#cite_note-Schett2017-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Schmitt2017_49-0" class="reference"><a href="#cite_note-Schmitt2017-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Apophysitis" class="mw-redirect" title="Apophysitis">Apophysitis</a>, inflammation of the bony attachment, generally associated with overuse among growing children.<sup id="cite_ref-Osgood-Schlatter_50-0" class="reference"><a href="#cite_note-Osgood-Schlatter-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Kidshealth_51-0" class="reference"><a href="#cite_note-Kidshealth-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid15555843_52-0" class="reference"><a href="#cite_note-pmid15555843-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=14" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The use of a <a href="/wiki/Nitric_oxide" title="Nitric oxide">nitric oxide</a> delivery system (<a href="/wiki/Glyceryl_trinitrate_(pharmacology)" class="mw-redirect" title="Glyceryl trinitrate (pharmacology)">glyceryl trinitrate</a> patches) applied over the area of maximal tenderness was found to reduce pain and increase range of motion and strength.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> </p><p>A promising therapy involves <a href="/wiki/Muscle_contraction#Eccentric_contraction" title="Muscle contraction">eccentric loading</a> exercises involving lengthening muscular contractions.<sup id="cite_ref-Rowe-2012_54-0" class="reference"><a href="#cite_note-Rowe-2012-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Other_animals">Other animals</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=15" title="Edit section: Other animals"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Bowed_tendon" title="Bowed tendon">Bowed tendon</a> is a horseman's term for tendinitis (inflammation) and tendinosis (degeneration), most commonly seen in the superficial digital flexor tendon in the front leg of horses. </p><p><a href="/wiki/Mesenchymal_stem_cell" title="Mesenchymal stem cell">Mesenchymal stem cells</a>, derived from a horse's bone marrow or fat, are currently being used for tendon repair in horses.<sup id="cite_ref-pmid19412395_55-0" class="reference"><a href="#cite_note-pmid19412395-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tendinopathy&action=edit&section=16" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-AFP2005-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-AFP2005_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-AFP2005_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-AFP2005_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-AFP2005_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-AFP2005_1-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-AFP2005_1-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-AFP2005_1-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-AFP2005_1-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-AFP2005_1-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-AFP2005_1-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-AFP2005_1-10"><sup><i><b>k</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=British+Journal+of+Sports+Medicine&rft.atitle=Effect+of+resistance+exercise+dose+components+for+tendinopathy+management%3A+a+systematic+review+with+meta-analysis&rft.volume=57&rft.issue=20&rft.pages=1327-1334&rft.date=2023-10-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC10579176%23id-name%3DPMC&rft.issn=0306-3674&rft_id=info%3Apmid%2F37169370&rft_id=info%3Adoi%2F10.1136%2Fbjsports-2022-105754&rft.aulast=Pavlova&rft.aufirst=Anastasia+Vladimirovna&rft.au=Shim%2C+Joanna+S.+C.&rft.au=Moss%2C+Rachel&rft.au=Maclean%2C+Colin&rft.au=Brandie%2C+David&rft.au=Mitchell%2C+Laura&rft.au=Greig%2C+Leon&rft.au=Parkinson%2C+Eva&rft.au=Alexander%2C+Lyndsay&rft.au=Brown%2C+Victoria+Tzortziou&rft.au=Morrissey%2C+Dylan&rft.au=Cooper%2C+Kay&rft.au=Swinton%2C+Paul+A.&rft_id=https%3A%2F%2Fbjsm.bmj.com%2Fcontent%2F57%2F20%2F1327&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATendinopathy" class="Z3988"></span></span> </li> <li id="cite_note-30"><span class="mw-cite-backlink"><b><a href="#cite_ref-30">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation journal cs1"><a rel="nofollow" class="external text" href="https://evidence.nihr.ac.uk/alert/weights-resistance-bands-rest-days-best-tendinopathy/">"Weights, resistance bands and rest days are best for tendinopathy"</a>. <i>NIHR Evidence</i>. 15 February 2024. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3310%2Fnihrevidence_61938">10.3310/nihrevidence_61938</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=NIHR+Evidence&rft.atitle=Weights%2C+resistance+bands+and+rest+days+are+best+for+tendinopathy&rft.date=2024-02-15&rft_id=info%3Adoi%2F10.3310%2Fnihrevidence_61938&rft_id=https%3A%2F%2Fevidence.nihr.ac.uk%2Falert%2Fweights-resistance-bands-rest-days-best-tendinopathy%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATendinopathy" class="Z3988"></span></span> </li> <li id="cite_note-pmid19708800-31"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid19708800_31-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTumiltyMunnMcDonoughHurley2010" class="citation journal cs1">Tumilty S, Munn J, McDonough S, Hurley DA, Basford JR, Baxter GD (February 2010). "Low level laser treatment of tendinopathy: a systematic review with meta-analysis". <i>Photomedicine and Laser Surgery</i>. <b>28</b> (1): 3–16. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1089%2Fpho.2008.2470">10.1089/pho.2008.2470</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19708800">19708800</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:10634480">10634480</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Photomedicine+and+Laser+Surgery&rft.atitle=Low+level+laser+treatment+of+tendinopathy%3A+a+systematic+review+with+meta-analysis&rft.volume=28&rft.issue=1&rft.pages=3-16&rft.date=2010-02&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A10634480%23id-name%3DS2CID&rft_id=info%3Apmid%2F19708800&rft_id=info%3Adoi%2F10.1089%2Fpho.2008.2470&rft.aulast=Tumilty&rft.aufirst=S&rft.au=Munn%2C+J&rft.au=McDonough%2C+S&rft.au=Hurley%2C+DA&rft.au=Basford%2C+JR&rft.au=Baxter%2C+GD&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATendinopathy" class="Z3988"></span></span> </li> <li id="cite_note-32"><span class="mw-cite-backlink"><b><a href="#cite_ref-32">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLoewBrosseauTugwellWells2014" class="citation journal cs1">Loew LM, Brosseau L, Tugwell P, Wells GA, Welch V, Shea B, Poitras S, De Angelis G, Rahman P (2014-11-08). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154576">"Deep transverse friction massage for treating lateral elbow or lateral knee tendinitis"</a>. <i>Cochrane Database of Systematic Reviews</i>. <b>2014</b> (11): CD003528. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.cd003528.pub2">10.1002/14651858.cd003528.pub2</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1465-1858">1465-1858</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154576">7154576</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25380079">25380079</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cochrane+Database+of+Systematic+Reviews&rft.atitle=Deep+transverse+friction+massage+for+treating+lateral+elbow+or+lateral+knee+tendinitis&rft.volume=2014&rft.issue=11&rft.pages=CD003528&rft.date=2014-11-08&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7154576%23id-name%3DPMC&rft.issn=1465-1858&rft_id=info%3Apmid%2F25380079&rft_id=info%3Adoi%2F10.1002%2F14651858.cd003528.pub2&rft.aulast=Loew&rft.aufirst=Laurianne+M&rft.au=Brosseau%2C+Lucie&rft.au=Tugwell%2C+Peter&rft.au=Wells%2C+George+A&rft.au=Welch%2C+Vivian&rft.au=Shea%2C+Beverley&rft.au=Poitras%2C+Stephane&rft.au=De+Angelis%2C+Gino&rft.au=Rahman%2C+Prinon&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7154576&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATendinopathy" class="Z3988"></span></span> </li> <li id="cite_note-33"><span class="mw-cite-backlink"><b><a href="#cite_ref-33">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGaujoux-VialaDougadosGossec2009" class="citation journal cs1">Gaujoux-Viala C, Dougados M, Gossec L (December 2009). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770107">"Efficacy and safety of steroid injections for shoulder and elbow tendonitis: a meta-analysis of randomised controlled trials"</a>. <i>Ann. Rheum. Dis</i>. <b>68</b> (12): 1843–9. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fard.2008.099572">10.1136/ard.2008.099572</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770107">2770107</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19054817">19054817</a>. <q>Conclusions: Steroid injections are well tolerated and more effective for tendonitis in the short-term than pooled other treatments, though similar to NSAIDs. No long-term benefit was shown.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Ann.+Rheum.+Dis.&rft.atitle=Efficacy+and+safety+of+steroid+injections+for+shoulder+and+elbow+tendonitis%3A+a+meta-analysis+of+randomised+controlled+trials&rft.volume=68&rft.issue=12&rft.pages=1843-9&rft.date=2009-12&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2770107%23id-name%3DPMC&rft_id=info%3Apmid%2F19054817&rft_id=info%3Adoi%2F10.1136%2Fard.2008.099572&rft.aulast=Gaujoux-Viala&rft.aufirst=C&rft.au=Dougados%2C+M&rft.au=Gossec%2C+L&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2770107&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATendinopathy" class="Z3988"></span></span> </li> <li id="cite_note-34"><span class="mw-cite-backlink"><b><a href="#cite_ref-34">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMohamadiChanClaessenRing2017" class="citation journal cs1">Mohamadi A, Chan JJ, Claessen FM, Ring D, Chen NC (January 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174041">"Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendinosis: A Meta-analysis"</a>. <i>Clinical Orthopaedics and Related Research</i>. <b>475</b> (1): 232–243. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs11999-016-5002-1">10.1007/s11999-016-5002-1</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174041">5174041</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27469590">27469590</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+Orthopaedics+and+Related+Research&rft.atitle=Corticosteroid+Injections+Give+Small+and+Transient+Pain+Relief+in+Rotator+Cuff+Tendinosis%3A+A+Meta-analysis.&rft.volume=475&rft.issue=1&rft.pages=232-243&rft.date=2017-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5174041%23id-name%3DPMC&rft_id=info%3Apmid%2F27469590&rft_id=info%3Adoi%2F10.1007%2Fs11999-016-5002-1&rft.aulast=Mohamadi&rft.aufirst=A&rft.au=Chan%2C+JJ&rft.au=Claessen%2C+FM&rft.au=Ring%2C+D&rft.au=Chen%2C+NC&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5174041&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATendinopathy" class="Z3988"></span></span> </li> <li id="cite_note-35"><span class="mw-cite-backlink"><b><a href="#cite_ref-35">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDeanLostisOakleyRombach2014" class="citation journal cs1">Dean BJ, Lostis E, Oakley T, Rombach I, Morrey ME, Carr AJ (February 2014). 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Seminars+in+Arthritis+and+Rheumatism&rft.atitle=The+risks+and+benefits+of+glucocorticoid+treatment+for+tendinopathy%3A+a+systematic+review+of+the+effects+of+local+glucocorticoid+on+tendon.&rft.volume=43&rft.issue=4&rft.pages=570-6&rft.date=2014-02&rft_id=info%3Adoi%2F10.1016%2Fj.semarthrit.2013.08.006&rft_id=info%3Apmid%2F24074644&rft.aulast=Dean&rft.aufirst=BJ&rft.au=Lostis%2C+E&rft.au=Oakley%2C+T&rft.au=Rombach%2C+I&rft.au=Morrey%2C+ME&rft.au=Carr%2C+AJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATendinopathy" class="Z3988"></span></span> </li> <li id="cite_note-36"><span class="mw-cite-backlink"><b><a href="#cite_ref-36">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKearneyParsonsMetcalfeCosta2015" class="citation journal cs1">Kearney RS, Parsons N, Metcalfe D, Costa ML (26 May 2015). 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Sports+Med&rft.atitle=Conservative+management+of+midportion+Achilles+tendinopathy%3A+a+mixed+methods+study%2C+integrating+systematic+review+and+clinical+reasoning&rft.volume=42&rft.issue=11&rft.pages=941-67&rft.date=2012-11&rft_id=info%3Adoi%2F10.2165%2F11635410-000000000-00000&rft_id=info%3Apmid%2F23006143&rft.aulast=Rowe&rft.aufirst=V&rft.au=Hemmings%2C+S&rft.au=Barton%2C+C&rft.au=Malliaras%2C+P&rft.au=Maffulli%2C+N&rft.au=Morrissey%2C+D&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATendinopathy" class="Z3988"></span></span> </li> <li id="cite_note-pmid19412395-55"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid19412395_55-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKochBergBetts2009" class="citation journal cs1">Koch TG, Berg LC, Betts DH (2009). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629419">"Current and future regenerative medicine - principles, concepts, and therapeutic use of stem cell therapy and tissue engineering in equine medicine"</a>. <i>Can Vet J</i>. <b>50</b> (2): 155–65. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629419">2629419</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19412395">19412395</a>.</cite><span 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ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q1682583" class="extiw" title="d:Q1682583">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1335136978%2Funspecified">FB55.Z</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/M77.9">M77.9</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=726.90">726.90</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D052256">D052256</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb31624.htm">31624</a></li><li><b><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a></b>: <a rel="nofollow" class="external text" href="http://snomed.info/id/68172002">68172002</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/001229.htm">001229</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/emerg/570-overview">emerg/570</a></li></ul></div></div></td></tr></tbody></table></div> <p><br /> </p> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" 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a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Soft_tissue_disorders" title="Template:Soft tissue disorders"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Soft_tissue_disorders" title="Template talk:Soft tissue disorders"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Soft_tissue_disorders" title="Special:EditPage/Template:Soft tissue disorders"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Soft_tissue_disorders" style="font-size:114%;margin:0 4em"><a href="/wiki/Soft_tissue_disorder" class="mw-redirect" title="Soft tissue disorder">Soft tissue disorders</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Capsular<br />joint</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Synovial_membrane" title="Synovial membrane">Synoviopathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Synovitis" title="Synovitis">Synovitis</a>/<a href="/wiki/Tenosynovitis" title="Tenosynovitis">Tenosynovitis</a> <ul><li><a href="/wiki/Calcific_tendinitis" title="Calcific tendinitis">Calcific tendinitis</a></li> <li><a href="/wiki/Trigger_finger" title="Trigger finger">Stenosing tenosynovitis (Trigger finger)</a></li> <li><a href="/wiki/De_Quervain_syndrome" title="De Quervain syndrome">De Quervain syndrome</a></li></ul></li> <li><a href="/wiki/Transient_synovitis" title="Transient synovitis">Transient synovitis</a></li> <li><a href="/wiki/Ganglion_cyst" title="Ganglion cyst">Ganglion cyst</a></li></ul> <ul><li><i><a href="/wiki/Osteochondromatosis" title="Osteochondromatosis">osteochondromatosis</a></i> <ul><li><a href="/wiki/Synovial_osteochondromatosis" title="Synovial osteochondromatosis">Synovial osteochondromatosis</a></li></ul></li> <li><a href="/wiki/Plica_syndrome" title="Plica syndrome">Plica syndrome</a></li></ul> <ul><li><i><a href="/wiki/Villonodular_synovitis" title="Villonodular synovitis">villonodular synovitis</a></i> <ul><li><a href="/wiki/Tenosynovial_giant_cell_tumor" title="Tenosynovial giant cell tumor">Tenosynovial giant cell tumor</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Synovial_bursa" title="Synovial bursa">Bursopathy</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bursitis" title="Bursitis">Bursitis</a> <ul><li><a href="/wiki/Olecranon_bursitis" title="Olecranon bursitis">Olecranon</a></li> <li><a href="/wiki/Prepatellar_bursitis" title="Prepatellar bursitis">Prepatellar</a></li> <li><a href="/wiki/Greater_trochanteric_pain_syndrome" title="Greater trochanteric pain syndrome">Trochanteric</a></li> <li><a href="/wiki/Subacromial_bursitis" title="Subacromial bursitis">Subacromial</a></li> <li><a href="/wiki/Achilles_bursitis" title="Achilles bursitis">Achilles</a></li> <li><a href="/wiki/Retrocalcaneal_bursitis" title="Retrocalcaneal bursitis">Retrocalcaneal</a></li> <li><a href="/wiki/Ischial_bursitis" title="Ischial bursitis">Ischial</a></li> <li><a href="/wiki/Iliopsoas_bursitis" title="Iliopsoas bursitis">Iliopsoas</a></li></ul></li> <li><a href="/wiki/Ganglion_cyst" title="Ganglion cyst">Synovial cyst</a> <ul><li><a href="/wiki/Baker%27s_cyst" title="Baker's cyst">Baker's cyst</a></li></ul></li> <li><a href="/wiki/Calcific_bursitis" title="Calcific bursitis">Calcific bursitis</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Noncapsular<br />joint</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Symptoms</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ligamentous_laxity" title="Ligamentous laxity">Ligamentous laxity</a></li> <li><a href="/wiki/Hypermobility_(joints)" title="Hypermobility (joints)">Hypermobility</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Enthesopathy" title="Enthesopathy">Enthesopathy</a>/<br /><a href="/wiki/Enthesitis" title="Enthesitis">Enthesitis</a>/<br /><a class="mw-selflink selflink">Tendinopathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>upper limb</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adhesive_capsulitis_of_the_shoulder" title="Adhesive capsulitis of the shoulder">Adhesive capsulitis of the shoulder</a></li> <li><a href="/wiki/Shoulder_impingement_syndrome" title="Shoulder impingement syndrome">Shoulder impingement syndrome</a></li> <li><a href="/wiki/Shoulder_injury_related_to_vaccine_administration" title="Shoulder injury related to vaccine administration">Shoulder injury related to vaccine administration</a></li> <li><a href="/wiki/Rotator_cuff_tear" title="Rotator cuff tear">Rotator cuff tear</a></li> <li><a href="/wiki/Golfer%27s_elbow" title="Golfer's elbow">Golfer's elbow</a></li> <li><a href="/wiki/Tennis_elbow" title="Tennis elbow">Tennis elbow</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>lower limb</i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Iliotibial_band_syndrome" title="Iliotibial band syndrome">Iliotibial band syndrome</a></li> <li><a href="/wiki/Patellar_tendinitis" title="Patellar tendinitis">Patellar tendinitis</a></li> <li><a href="/wiki/Achilles_tendinitis" title="Achilles tendinitis">Achilles tendinitis</a></li> <li><a href="/wiki/Calcaneal_spur" title="Calcaneal spur">Calcaneal spur</a></li> <li><a href="/wiki/Metatarsalgia" title="Metatarsalgia">Metatarsalgia</a></li> <li><a href="/wiki/Osteophyte" title="Osteophyte">Bone spur</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i>other/general:</i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tendinitis" class="mw-redirect" title="Tendinitis">Tendinitis</a>/<a href="/wiki/Tendinosis" class="mw-redirect" title="Tendinosis">Tendinosis</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Nonjoint</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Fascia" title="Fascia">Fasciopathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fasciitis" title="Fasciitis">Fasciitis</a>: <a href="/wiki/Plantar_fasciitis" title="Plantar fasciitis">Plantar</a></li> <li><a href="/wiki/Nodular_fasciitis" title="Nodular fasciitis">Nodular</a></li> <li><a href="/wiki/Necrotizing_fasciitis" title="Necrotizing fasciitis">Necrotizing</a></li> <li><a href="/wiki/Eosinophilic_fasciitis" title="Eosinophilic fasciitis">Eosinophilic</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Fibromatosis" title="Fibromatosis">Fibromatosis</a>/<a href="/wiki/Contracture" title="Contracture">contracture</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Dupuytren%27s_contracture" title="Dupuytren's contracture">Dupuytren's contracture</a></li> <li><a href="/wiki/Plantar_fibromatosis" title="Plantar fibromatosis">Plantar fibromatosis</a></li> <li><a href="/wiki/Aggressive_fibromatosis" title="Aggressive fibromatosis">Aggressive fibromatosis</a></li> <li><a href="/wiki/Knuckle_pads" title="Knuckle pads">Knuckle pads</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; 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