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Posted on Nov 05, 2014 at


The defeat of the tendon can be represented as tendinitis, tendinosis and tenosynovitis:
Tendinitis occurs because of tendon injury and it’s usually associated with the destruction of the vessels and the acute, subacute or chronic inflammation.
Tendinosis is a noninflammatory atrophy and degeneration of the fibers within the tendon. Tendinosis is often associated with chronic tendinitis, which can lead to partial or complete rupture of the tendon.
Tenosynovitis is a proccess, associated with an inflammation of synovial membrane.
In this review lets pay attention to stress injuries caused by frequent repetitive monotonous movements, that is, an overexertion. In most cases these injuries require surgical treatment (for example – the damage of anterior cruciate ligament and collateral ligaments of the knee, Achilles tendon rupture).

The most common types of injuries caused by overexertion (overtraining):
ligament injuries: baseball elbow, knee of the swimmer, iliotibial band friction syndrome (ITBFS), knee of the jumper, plantar fasciitis;
tendon injuries: Achilles tendinitis, suprapatellar tendinitis, biceps tendinitis, posterior tibial muscle tendinitis, lateral epicondylitis (tennis elbow), tendinitis of supraspinatus muscle (or cuff rotator muscle).
Tennis elbow is lateral epicondylitis. This syndrome is caused by overtraining and it manifests with pain on the lateral surface of the elbow joint. Patients usually note, that it appear during a game of tennis. Nowadays, lateral epicondylitis is an inflammatory disease and/or microscopic discontinuities in the place of attachment of the short radial extensor muscle to wrist (musculus extensor carpi brevis). A provocative move for lateral epicondylitis is forced extension of the middle finger against the resistance. It causes pain because short radial extensor muscle is attached to the base of the metacarpus of the middle finger.
Golfer’s elbow – is medial epicondylitis. It occurs from overtraining when tendons of flexor muscles and pronator muscles of forearm are damaged at the site of their attachment to the medial epicondyle. This area is subjected to valgus position of a forearm at the top of the ball swing. Usually golf players complain of the pain over the medial epicondyle, getting worse on forearm bending and pronation.
Baseball elbow (inflammation of the medial apophysis) occurs due to valgus force caused by frequent movement of the arm to throw a ball. Such patients usually have microscopic ruptures of muscular tendons (of flexor and pronator muscles). In severe cases even separation and fragmentation of the medial apophysis may be occured.
Iliotibial band friction syndrome (ITBFS) – is a pain on the lateral surface of the knee due to irritation and inflammation of the distal Iliotibial band as it passes over the lateral condyle of the femur. The pain increases on palpation of the distal part of the band at the time of leg extension in the knee joint. ITBFS usually occurs when over-running, running over rough terrain.
Swimmer’s knee – is a condition arising in the knee joint when the force on it is proceed in valgus direction due to sharp movements of the leg while swimming (especially with breaststroke style). Usually it is occurs like a tension of the medial collateral ligament of the knee. It often causes a pain.
Jumper knee it is so-called patella tendinitis. It often occurs in a high jumpers, basketball and volleyball players. It’s characterized by the pain in the lower part of the patella in place of an attachment of patellar ligament. This syndrome develops due to permanent damage of this area, associated with the absence of recovery and complete healing of trauma.
Biceps tendinitis manifests itself with a pain in front of the shoulder joint, which is enhanced by active movements of the shoulder joint and calms down or absent on passive movements. Usually it is accompanied by local tenderness on palpation over the region of the long head biceps tendon. If the biceps tendinitis is accompanied by myositis – severe muscle soreness bring a large inconvenience to patients.
Patellar bursitis is accompanied by pain, edema and local increase of temperature in the patellar bag (it is closer to the surface than patellar bone). Bursitis is caused by repeated trauma or stress (such like standing on the knees).
Achilles tendinitis (inflammation of the Achilles tendon) is manifested with a pain in the heel, and sometimes pain in the back of the leg. Any flexion of the foot (no matter dorsal flexion or plantar flexion) makes the pain to increase. The most painful area is located at 2-3 cm proximal to the junction of the tendon with the heel bone. The tendon may be edematous and thickened (the most often cause is spondyloarthropathy with the involvement of the peripheral joints – Reiter’s disease or ankylosing spondylitis).
Plantar fasciitis or heel spurs anatomically arises from the insertion of the short flexor of fingers, localized at anteromedial edge of the calcaneal tuberosity, some deeper than the insertion of the plantar fascia. Overexertion of one of these structures is considered to give a rise to reactive inflammatory of the bone. Heel spurs forms secondary after the traction of these structures. However, it remains unclear which of the mechanisms is definitely responsible for it. In any case spur is secondary to the strain.
Also there’s a special pathology, as shin splints. It is a overtraining damage caused by chronic traction of periosteum of the tibia. In this case, tibial muscles, or musculus soleus are affected. Shin splints is characterized by gradually starting pain in anteromedial or posteriomedial surface of the tibia. The pain occurs in athletes at the start of the race, it comes down while running and re-amplifies after the race. On palpation tenderness is most severe in posteriomedial edge of the tibia, usually between the middle and lower thirds. Pain increases with dorsal flexion of the foot against resistance.

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