Peter A. Huijbregts, MSc, MHSc, PT
Scott E. Smith, MSc, OT
Abstract: This article describes the biomechanical and biochemical aspects of tendon anatomy and function, response of the tendon to injury, and factors contributing to injury. Clinical implications for treating patients with tendon injury are discussed.
Key Words: Tendon, Biochemical, Biomechanical, Injury, Anatomy, Function, Contributing
Patients with tendon injuries are commonly referred to physical and occupational therapists. Traditionally, the term tendonitis has been used for virtually all painful afflictions of tendon structures, their synovial sheaths, and even adjacent bursae1. Mounting pathologic evidence, however, distinguishes between the acute traumatic inflammatory response of tendonitis and the more insidious process of chronic tendon degeneration1. This chronic degeneration is thought to be caused by over-use, and overuse tendon injuries are estimated to account for 30 to 50% of all sports-related injuries in the US2,3. Most industrial patients will also present with a slow insidious onset consistent with overuse tendon injuries.
This article provides the physical and occupationaltherapist with the information necessary to make better informed treatment decisions for both acute, and chronic tendon injuries. We review tendon anatomy and function, response to injury, contributing factors to injury, and clinical relevance. This article is limited to issues related to the tendon midportion touching upon musculotendinous and osseotendinous junction issues only peripherally.