- Part 1 Introduction to musculoskeletal medicine
- Part 2 Structural pathology; dysfunction; pain
- Part 3 Regional disorders
- Chapter 23 Clinical examination
- Chapter 24 Investigative techniques
- Chapter 25 Musculoskeletal injections
- Chapter 26 Endoscopically determined pain sources in the lumbar spine
- Chapter 27 Regional somatic dysfunction
- Chapter 28 Thoracic outlet syndrome
- Chapter 29 Chest wall pain
- Chapter 30 The joints of the shoulder girdle
- Chapter 31 Structural disorders of the shoulder
- Chapter 32 Rehabilitation strategies—shoulder disorders
- Chapter 33 Upper limb disorders
- Chapter 34 The pelvis
- Chapter 35 Sacroiliac joint disorders
- Chapter 36 Structural disorders of the knee
- Chapter 37 Patellofemoral/extensor mechanism disorders
- Chapter 38 Soft tissue injuries at the knee
- Chapter 39 Superior tibiofibular joint
- Chapter 40 Exertional lower leg pain
- Chapter 41 Biomechanics of the foot and ankle
- Chapter 42 The ankle joint
- Chapter 43 The subtalar joint
- Chapter 44 Plantar fasciitis and heel pain
- Chapter 45 Tendinopathies and enthesopathies
- Chapter 46 Metatarsalgia
- Chapter 47 Podiatry (podiatric medicine and surgery)
- Part 4 Management strategies
(p. 483) Tendinopathies and enthesopathies
- Chapter:
- (p. 483) Tendinopathies and enthesopathies
- Author(s):
Thomas Crisp
- DOI:
- 10.1093/med/9780199674107.003.0045
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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- Part 1 Introduction to musculoskeletal medicine
- Part 2 Structural pathology; dysfunction; pain
- Part 3 Regional disorders
- Chapter 23 Clinical examination
- Chapter 24 Investigative techniques
- Chapter 25 Musculoskeletal injections
- Chapter 26 Endoscopically determined pain sources in the lumbar spine
- Chapter 27 Regional somatic dysfunction
- Chapter 28 Thoracic outlet syndrome
- Chapter 29 Chest wall pain
- Chapter 30 The joints of the shoulder girdle
- Chapter 31 Structural disorders of the shoulder
- Chapter 32 Rehabilitation strategies—shoulder disorders
- Chapter 33 Upper limb disorders
- Chapter 34 The pelvis
- Chapter 35 Sacroiliac joint disorders
- Chapter 36 Structural disorders of the knee
- Chapter 37 Patellofemoral/extensor mechanism disorders
- Chapter 38 Soft tissue injuries at the knee
- Chapter 39 Superior tibiofibular joint
- Chapter 40 Exertional lower leg pain
- Chapter 41 Biomechanics of the foot and ankle
- Chapter 42 The ankle joint
- Chapter 43 The subtalar joint
- Chapter 44 Plantar fasciitis and heel pain
- Chapter 45 Tendinopathies and enthesopathies
- Chapter 46 Metatarsalgia
- Chapter 47 Podiatry (podiatric medicine and surgery)
- Part 4 Management strategies