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Tendinopathies and enthesopathies 

Tendinopathies and enthesopathies
Chapter:
Tendinopathies and enthesopathies
Author(s):

Thomas Crisp

DOI:
10.1093/med/9780199674107.003.0045
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date: 23 October 2020

Adult ligaments and tendons are very similar collagenized structures, composed of largely type 1 collagen in tight bands, with very little type III collagen. The fluid between the fibrils contains proteoglycans and a small number of elastic fibres. The number and type of collagen fibrils correlates closely with the tensile strength. The tendon is able to stretch up to about 4% without any loss of structure and tearing occurs after this point up to complete rupture at about 10% stretch. Constant turnover of collagen is carried out by tenocytes in the tendon and changes occur to this process in tendinopathy. Such changes may cause more water to be held in the tendon, thereby contributing to swelling of the tendon. Metalloproteinases, which show increased levels in painful tendinopathy, play an undetermined role in this degradation process. The increase in neuropeptides in degenerate tendons is also thought to play a part.

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