​Tendinopathy


Tendons are the soft but tough fibres which link your muscles to bone. When your muscles contract, the tendons pull your bones and enable your joints to move. 

Tendinopathy or tendon injuries refer to painful injuries that take place in or around your tendon, usually near a joint such as your shoulder. Other common sites of tendon injury are your elbows, ankles, knees and fingers. A tendon injury may occur to have happened suddenly. However, most injuries usually occur over time and are the result of many small tears in your tendon. In some instances you may experience pain due to inflammation which can occur around calcium crystal deposits which form in or around the tendon (calcific tendinitis).

Anyone can suffer a tendon injury. However, you are more prone to tendon damage if you make the same repetitive motions often, for example due to the nature of your job, contact sports or a daily activity.

Your doctor may describe your injury using different terms, such as:

  • Tendinitis – this refers to inflammation of the tendon.

  • Tendinosis – this describes tiny tears that develop in the tissues that are in or that surround a tendon as a result of overuse or aging.  

The most preferred term used by experts is tendinopathy, which encompasses both inflammation and micro-tears.


The symptoms of tendinopathy may include:

  • Pain or tenderness – near the injured tendon

  • Redness, swelling and/or warmth – occurring near the injured tendon

  • Pain that radiates – out from the site of the injury

  • Crepitus –  an uncomfortable “crunchy” sound or sensation when the tendon is being used

  • Stiffness and loss of strength – this may be worse at night or when waking up in the morning

If you experience any of the symptoms of a tendon injury, you should seek advice from a doctor working with the Musculoskeletal and Sports Medicine Service Line at The Aga Khan University Hospital to prevent the damage from becoming worse. 

Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

The diagnosis for a tendon injury will begin with a review of your medical history as well as of your daily activities that could have spurred damage. Your doctor will then conduct a physical examination which will include inspecting the areas of pain and tenderness.


The review of your medical history and the physical examination may be enough to make a diagnosis for a tendon injury. However you may need to undergo further tests if your symptoms are indicative of a tendon injury, or if you have been diagnosed with a tendon injury that has not improved with treatment. These may include:

  • X-rays – this may show any bone-related issues or make clear your tendons or structures of your joints.

  • Magnetic Resonance Imaging (MRI) – this will highlight any tiny tears and areas of the tendon, ligament, muscles injury and cartilage.

  • Ultrasound – this will help to indicate thickening, swelling or tiny tears in soft tissues.

Typically, the initial treatment for a tendon injury consists of pain relievers, plenty of rest and applying ice to the site of the injury. Medication prescribed by the doctor may reduce the pain. Your doctor may also suggest range-of-motion exercises to do daily in order to restore full strength, range and motion in your joint and to prevent stiffness.

The aim of this primary treatment is to:

  • Lessen pain and inflammation in the tendon

  • Bring back normal motion and strength

If the pain, stiffness and swelling still persist after the initial treatment, your doctor may suggest physical therapy and long-term changes in the types or manner of activities you engage in that may aggravate an injury. On-going treatment aims to reduce long-term pain, degeneration or tearing in the tendon and to encourage restoration of the injured tendon.

Surgery is the last treatment option to be considered if the problem persists after other options have been exhausted. The surgical option may be viable for those that have extensive injuries and are experiencing great pain and difficulty that cannot be alleviated through the other treatment options.  The aim of a surgical repair is to bring back normal movement and range to your joint.

Please click here for some guidelines on “what to do before your surgery”

Please click here for some guidelines on “what to do on the day of your surgery”

There are some risks associated with anaesthesia, such as pain, itching, diarrhoea or difficulty breathing. The risks of surgical procedures in general include bleeding and infection. Some specific possible risks associated with surgical tendon repair include:

  • Scar tissue –  this may prevent the joints from moving correctly

  • Loss of some joint use

  • Stiffness in the join

  • Re-tear

Please click here for some guidelines on “what to do on after your surgery”

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
 
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.
 
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.



​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.