Tendinitis: Most Effective Supplements

Tendinitis is an inflammation of a tendon, the fibrous structure connecting muscles to bones. Although the term "tendinitis" is often used, the medical community now favors the word "tendinopathy" to encompass a broader spectrum of conditions including structural alterations, pain, and reduced tendon functions. Tendinopathies primarily affect the tendons of the shoulders, elbows, knees, and ankles, and can be caused by repetitive overloads, trauma, or metabolic and hormonal imbalances.

Pathophysiology of Tendinopathy

Tendinopathy involves complex modifications of tendon structure and composition. Normally composed of well-organized collagen fibers, tendinopathic tendons show fiber disorganization, increased blood vessels (neovascularization), and infiltration of sensory nerves. These alterations reduce the tendons' capacity to withstand mechanical loads. Furthermore, subtle inflammatory processes, once ignored, are now recognized as important. Inflammatory cytokines, such as IL-6 and TNF-alpha, disrupt the balance between collagen synthesis and degradation. This leads to excessive production of type III collagen, which is less robust, compromising tendon strength. Tendinopathies are often multi-factorial: • Intrinsic factors: age, gender, metabolic disorders (diabetes, obesity), muscle weakness or biomechanical imbalances. • Extrinsic factors: repetitive movements, mechanical overload, or the use of certain medications such as corticosteroids or fluoroquinolone antibiotics.

Symptoms and Diagnosis

Typical symptoms include localized pain, stiffness, and sometimes functional weakness. These pains are often exacerbated by physical activity and relieved at rest. The diagnosis is based on a thorough clinical examination, with particular attention to pain caused by specific movements. Imaging techniques, such as ultrasound or MRI, can be used to confirm the diagnosis and assess structural damage.

Tendinitis Treatments

The treatment of tendinitis relies on a combination of approaches aimed at relieving pain, reducing inflammation, and restoring tendon function. Rest and Activity Modifications: Rest is essential to reduce the mechanical overload on the tendon. However, prolonged immobilization is discouraged as it may further weaken the tendon. It is often recommended to adapt movements or sports activities to avoid repeated tension. Eccentric Exercises: Considered the cornerstone of conservative treatment, these exercises gradually strengthen the tendon by elongating its fibers under tension. Their effectiveness is demonstrated for Achilles tendon, knee, and elbow tendinopathies. Physical Therapy: Techniques like deep transverse massages, specific stretches, and electrotherapy (such as ultrasound) help improve local circulation and promote healing. Platelet-Rich Plasma (PRP) Injections: This therapy involves injecting a concentration of platelets directly into the affected area. It stimulates tissue regeneration by releasing growth factors, although results vary according to studies. Corticosteroids: Used for rapid pain relief, these injections should be limited to acute cases. Prolonged use may weaken the tendon and slow its recovery. Extracorporeal Shock Wave Therapy: This non-invasive method sends mechanical pulses to the tendon, stimulating regeneration and reducing chronic pain. Low-Intensity Laser: Known for its ability to modulate inflammation and accelerate repair, this approach is promising in some types of tendinitis. In refractory cases where conservative treatments fail after several months, surgery may be considered. After treatment, supervised rehabilitation remains essential to strengthen surrounding muscles and restore mobility.