Tendinopathy
Load-related tendon pain. The continuum model, systemic causes to look for (fluoroquinolones, familial hypercholesterolaemia, spondyloarthritis, gout), progressive loading as the treatment, why steroid injections and PRP disappoint, and when a tendon has ruptured.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Tendinopathy is pain and impaired function in a tendon related to load (ICON 2019). The tissue shows disorganised collagen and new vessels, with little inflammation in chronic disease.
- Commonest sites: rotator cuff, lateral elbow, gluteal tendons, patellar tendon, Achilles. Shoulder, elbow and hip specifics, with the CSAW, Coombes and LEAP trials, are in regional musculoskeletal conditions.
- Progressive loading exercise for 12 weeks or more is the treatment with the best evidence. Rest alone weakens the tendon.
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Sources
- Therapeutic Guidelines: Rheumatology (soft tissue rheumatic conditions)AU/NZTherapeutic Guidelines Limited (eTG complete), current online version, accessed November 2026
- Scott A et al. ICON 2019: International Scientific Tendinopathy Symposium Consensus: clinical terminology. Br J Sports Med 2020;54:260-2British Journal of Sports Medicine, 2019 (published 2020)
- Chimenti RL et al. Achilles pain, stiffness, and muscle power deficits: midportion Achilles tendinopathy revision 2024. J Orthop Sports Phys Ther 2024;54(12):CPG1-CPG32Academy of Orthopaedic Physical Therapy (APTA), 2024
- Desmeules F et al. Rotator cuff tendinopathy diagnosis, nonsurgical medical care, and rehabilitation: a clinical practice guideline. J Orthop Sports Phys Ther 2025;55:235-74Journal of Orthopaedic and Sports Physical Therapy, 2025
- de Vos RJ et al. Dutch multidisciplinary guideline on Achilles tendinopathy. Br J Sports Med 2021;55:1125-34British Journal of Sports Medicine, 2021
- Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med 2009;43:409-16British Journal of Sports Medicine, 2009
- Kearney RS et al. Effect of platelet-rich plasma injection vs sham injection on tendon dysfunction in patients with chronic midportion Achilles tendinopathy (ATM trial). JAMA 2021;326:137-44JAMA, 2021
- APO-Ciprofloxacin (ciprofloxacin) Australian product informationAU/NZTherapeutic Goods Administration, 12 November 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy