Sehneninsuffizienz

Sehneninsuffizienz, also known as tendinopathy or tendon dysfunction, refers to a condition where a tendon is unable to withstand the load placed upon it, leading to pain and reduced function. This is not a sudden tear, but rather a degenerative process that develops over time due to overuse, repetitive strain, or inadequate healing.

The underlying pathology involves changes within the tendon structure. The collagen fibers, which provide the tendon's strength, can become disorganized, thickened, and may show evidence of microtears. Blood supply to the affected area can also be compromised, hindering the body's natural repair mechanisms.

Common causes include engaging in activities that involve repetitive movements, sudden increases in training intensity or duration, or improper biomechanics. Age-related changes in tendon elasticity and reduced muscle strength can also contribute.

Symptoms typically include pain, which may be sharp during activity and dull at rest, tenderness to touch, stiffness, and a gradual loss of strength or function in the affected limb. The specific location of symptoms depends on which tendon is involved, such as the Achilles tendon, rotator cuff tendons, or tendons in the wrist and elbow.

Diagnosis is usually based on a physical examination and a review of the patient's medical history. Imaging studies like ultrasound or MRI may be used to assess the extent of tendon damage.

Treatment focuses on reducing inflammation, pain relief, and restoring tendon function. This often involves rest from aggravating activities, ice application, pain medication, and physiotherapy. Physiotherapy may include exercises to strengthen surrounding muscles, improve flexibility, and gradually reintroduce load to the affected tendon. In some cases, corticosteroid injections or surgery may be considered, though these are typically reserved for more severe or persistent cases. Prevention strategies include proper warm-up and cool-down routines, gradual progression of activity, and maintaining good biomechanics.