The tendons serve as connecting pieces between bones and muscle strands and thus make an essential contribution to upright posture. In order to fulfill their function in the human body, the tendons must be extremely resistant. If a tendon injury occurs, its function is impaired.
The following article describes what types of tendon injuries there are and how they are treated. You can also find specialists for the treatment of tendon injuries here.
Tendons are connective tissue connections between muscles and bones. Their function is to transfer the force of the muscle to the respective bone. This in turn is the basis for every joint movement and therefore the ability of humans to move. Tendons are therefore part of the so-called "holding apparatus" of the human body and sometimes have to withstand very high loads .
The tendons connect the muscles to the bones and enable movement @ BigBlueStudio /AdobeStock
If the tendons become diseased or injured, they lose their ability to function and the affected muscle loses contact with the bone.
There are chronic diseases of tendons, which are often caused by inflammation or overloading. These are also referred to as degenerative diseases, which are mainly caused by signs of wear and tear. The risk of degenerative tendon diseases increases with age.
However, the most common disease, which is discussed in more detail below, is acute (sudden and accident-related) tendon injuries. These occur
The latter includes, for example, a cut with a sharp tendon severance, although this is rather rare.
Although acute tendon injuries are more common than chronic injuries, it should be emphasized at this point that in many cases there is a combination of acute and chronic injuries. For example, a tendon rupture can occur after a comparatively minor use of force and a minor accident if the tendons are already degeneratively damaged. Consequently, the risk of a tendon injury due to an accident also increases with age.
Tendon injuries are usually caused by direct force . Severed tendons are usually the result of injuries caused by a sharp object. However, the most common form of tendon injury is a tendon tear or rupture. This disrupts the contact between muscle and bone, which restricts muscle function - i.e. the support of the bone during movement.
Tendon ruptures occur particularly frequently as a result of sudden overloading and overstretching. Athletes who expose their bodies to continuous strain - for example during long hikes in the mountains - are particularly often affected. However, injury is also possible as a result of falls or twisting of the joint. Spontaneous tendon ruptures occur if there is already previous damage - for example as part of a rheumatic disease. This is particularly true of older people, whose tendons are subject to greater wear and tear and are therefore more susceptible to tears.
A common cause of complaints in the tendon area are injuries that occur as a result of overloading or incorrect loading. This leads to overstretching or ruptures or tendon tears as a result of external influences. The most common tendon injuries include ruptures of the biceps and Achilles tendon. Other typical tendon tears affect the extensor or flexor tendons of the hand, the patellar tendon and the quadriceps tendon.
The Achilles tendon is the strongest tendon in the human body @ Sebastian Kaulitzki /AdobeStock
For those affected, tendon injuries are usually accompanied by pain and swelling. In addition, the function of the muscle and the respective limb is restricted.
The most common symptoms that occur as a result of tendon injuries include pain in the affected area as well as instability and loss of function of the respective joint. In the case of a biceps tendon tear on the forearm and an Achilles tendon tear, for example, there is often a sudden, stabbing pain, followed by a larger bruise and a visible or palpable dent in the affected area. Tears to the extensor or flexor tendons of the hand can lead to pain, swelling and bruising. In addition, the affected fingers can no longer be moved properly.
Because tendons have a poorer blood supply compared to other tissues, the healing process often takes quite a long time. In addition, many sufferers do not take the necessary rest. As a result, the injury cannot heal completely, leading to chronic tendon disorders. This is particularly the case with tendons that are subject to heavy strain, such as the Achilles tendon.
The blood supply to the tendons comes from the vessels in the muscle, bone and tendon sheaths and is poor compared to other body tissues. In addition, tendons have few cells that divide slowly and therefore take a long time to heal in the event of injury.
The type of accident and the symptoms described by those affected often indicate a tendon injury. Typical symptoms include a sudden, sharp pain and visible swelling or bruising. Those affected are usually no longer able to perform certain movements.
In the case of a rupture of the tendons close to the knee joint, for example, such a loss of function can be seen in the fact that the patient can no longer extend the knee joint. Clinical tests are then used to specifically examine the movement sequences in question. To confirm the initial diagnosis, an ultrasound examination or magnetic resonance imaging (MRI) is helpful. Both procedures provide reliable results when it comes to diagnosing tendon tears.
Do you suspect you have a tendon injury? Then contact a suitable specialist as soon as possible. These include orthopaedists and trauma surgeons. These doctors often specialize in certain regions of the body, for example there are special knee surgeons or foot and ankle surgeons.
The best possible treatment for a tendon injury depends crucially on the tendon affected. The complete healing of a torn tendon usually requires surgical intervention. Conservative treatment is only possible in cases of partial tendon tears. While this type of therapy is carried out in a special splint or orthosis, the torn tendon stumps are rejoined during an operation. Alternatively, the tendon is attached directly to the bone using a special suturing procedure to improve stability. In order to relieve the strain on the suture and thus additionally secure the connection, a cerclage (wrap) made of wire and thread or additional securing using screws is often used.
The majority of tendon injuries heal well and the function of the joint is restored. However, sequelae and new tears can also occur.
According to study results, there is a slightly increased riskof the tendon rupturing again with conservative treatment. This is also referred to as recurrence or re-rupture. When deciding for or against surgery, the individual patient's needs should therefore also be taken into account.
If the patient opts for surgery, they have the choice between open and minimally invasive procedures. Open procedures provide a very good view of the affected area and therefore offer the best conditions for direct suturing. This is particularly advantageous for older tears, but at the same time there is a higher risk of scarring, adhesions and wound healing disorders.
Simple ruptures that have only recently occurred should therefore preferably be treated in a minimally invasive manner. A device specially developed for this purpose is used, with which long instruments are inserted through the skin into the joint via small incisions. These can be used to pull the torn tendon ends together and secure them with thick sutures. These can then be simply knotted together, stabilizing the tendon ends. Wound healing disorders occur very rarely due to the small incisions.
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