Tendons: Time to revisit inflammation
Chronic tendinopathy has been a subject of high interest amongst physiotherapists and other health care providers. Our knowledge regarding tendon problems has moved through various stages and different models have been formed.
To date, the idea of inflammation as the underlying factor for the pathological process of tendinopathy – known as “tendonitis” model - has been abandoned and we have shifted towards the “degenerative” model in which degeneration occurs in the absence of inflammation. Even though we have certainly made progress, referring to all cases as “degenerative” is as problematic as referring to all cases as “tendonitis”. This view governs our treatment strategies and rather more aggressive approaches are favored. However, there is a substantial, and growing, body of evidence indicating that ongoing tendon degeneration is an active process with involvement of many aspects of inflammation-mediated responses.
This paper highlights the fact that we might have gone a bit too far with dismissing the inflammatory factor and new anti-inflammatory modalities might actually provide a valuable alternative to current treatments.
> From: Rees et al., Br J Sports Med 48 (2014) 1553-1557. All rights reserved to The Author(s). Click here for the Pubmed summary.