Tendinitis: the most effective dietary supplements

Tendinitis is an inflammation of a tendon, the fibrous structure that connects 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 that include structural changes, pain, and impaired tendon function. Tendinopathies predominantly affect the tendons of the shoulders, elbows, knees, and ankles, and they can be caused by repetitive overload, trauma, or metabolic and hormonal imbalances.​

Pathophysiology of tendinopathy

Tendinopathy involves complex changes in tendon structure and composition. Normally composed of well-organized collagen fibers, tendinopathic tendons show fiber disorganization, increased blood vessels (neovascularization), and infiltration by sensory nerves. These alterations reduce the tendons' ability to withstand mechanical loads.​ In addition, subtle inflammatory processes, previously overlooked, 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 and compromises tendon strength.​ Tendinopathies are often multifactorial: • Intrinsic factors: age, sex, 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 worsened by physical activity and relieved by rest. Diagnosis is based on a thorough clinical examination, with particular attention to pain triggered by specific movements. Imaging techniques, such as ultrasound or MRI, can be used to confirm the diagnosis and assess structural damage.

Treatment of tendinopathies

Treatment for tendinopathies is based on a combination of approaches aimed at relieving pain, reducing inflammation, and restoring tendon function. Rest and activity modification: Rest is essential to reduce mechanical overload on the tendon. However, prolonged immobilization is discouraged because it can further weaken the tendon. It is often recommended to modify movements or sporting activities to avoid repetitive strain. Eccentric exercises: Considered the cornerstone of conservative treatment, these exercises progressively strengthen the tendon by lengthening its fibers under load. Their effectiveness is demonstrated for Achilles tendon, patellar tendon, and elbow tendinopathies. Physical therapy: Techniques such as deep transverse massage, specific stretching, 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 between studies. Corticosteroids: Used for rapid pain relief, these injections should be limited to acute cases. Prolonged use can weaken the tendon and slow its recovery. Extracorporeal shockwave therapy: This noninvasive method delivers mechanical impulses to the tendon, stimulating regeneration and reducing chronic pain. Low-level laser therapy: Known for its ability to modulate inflammation and accelerate repair, this approach is promising for certain types of tendinopathy. 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.