Tendons are flexible bands of connective tissue linking muscles to bones. They transmit force from muscle contractions to the skeletal system, enabling joint movement. They also absorb impact, protecting muscles during physical activity. Injuries are common, ranging from minor strains to complete ruptures, and can limit mobility and cause pain.
Types of Tendon Injuries
Tendon injuries fall into two main categories: acute and chronic. Acute injuries result from a sudden, forceful event, like trauma or abrupt movement that overstretches or overloads a tendon. An Achilles tendon rupture is a common example, occurring during activities with sudden push-off or forceful ankle movements, often described as a “pop” or “snap.” This involves immediate tearing of fibers.
Chronic tendon injuries, or tendinopathy, develop gradually from repetitive stress or overuse. It involves collagen degeneration within the tendon, leading to pain and reduced function. Activities like typing, gardening, or sports with repeated motions can contribute. While it can begin with small tears, inadequate rest can lead to a chronic issue.
Factors Affecting Tendon Repair
Tendon repair, natural or medical, depends on several factors. Injury severity plays a role; partial tears heal differently than complete ruptures. Location also matters, as limited blood supply can slow healing.
Patient factors like age and overall health influence outcomes. Younger, healthier individuals may heal faster than older individuals or those with conditions like diabetes. Injury chronicity also affects repair; acute injuries respond more favorably to early intervention. Mechanical factors, including load or stress, impact healing.
Treatment Options for Tendon Injuries
Treatment varies by injury type and severity, often starting with non-surgical approaches. Rest, ice, compression, and elevation (RICE) is a common initial protocol for acute injuries, reducing pain and swelling. This protects the injured area and controls inflammatory responses. Physical therapy is recommended to improve range of motion, strengthen surrounding muscles, and promote controlled loading.
Medications like non-steroidal anti-inflammatory drugs (NSAIDs) may manage pain and inflammation. Injections can provide targeted relief. Corticosteroid injections offer short-term pain relief by reducing inflammation but are used with caution, as repeated use may compromise tendon integrity. Platelet-rich plasma (PRP) injections, derived from a patient’s blood, are another option, believed to stimulate natural healing by delivering concentrated growth factors.
When non-surgical methods are insufficient, surgery may be necessary, especially for complete ruptures or severe chronic conditions. Direct repair involves stitching torn tendon ends together. If the tendon has retracted significantly or tissue quality is poor, graft procedures may use tissue from another body part or a donor to bridge the gap. Debridement, removing damaged tissue, can be part of surgical treatment for chronic tendinopathy. Technique depends on the specific tendon, injury extent, and patient factors.
Life After Tendon Repair
Following treatment, a structured rehabilitation program is essential for successful recovery and to regain full function. Physical therapy guides patients through exercises to gradually restore strength, flexibility, and range of motion. Protocols progress through inflammatory, proliferative, and remodeling phases, with specific exercises at each stage to support tissue healing and prevent stiffness.
Recovery timelines vary significantly, from a few weeks for minor strains to several months or up to a year for severe tears and surgical repairs. While some movement may return in initial weeks, rebuilding full strength and stability takes longer. Potential complications include scar tissue formation, which can limit movement, stiffness, and re-tearing. Adhesions, where the tendon sticks to surrounding tissues, can occur.
Preventing re-injury is a crucial aspect, often involving activity modifications and continued adherence to exercise programs. Gradual return to strenuous activities, proper warm-up and cool-down routines, and good biomechanics are important. Consistent follow-up ensures optimal healing and addresses potential issues early.