Musculo-skeletal   [back to the Category]

General comments on tendinous trauma and microtrauma   [read the french version]

Author :   Docteur Anne Thiescé

Tendinous affections, together with cases of tendinitis, more accurately called tendinopathy, involve the tendon itself, its junction with the muscle as well as its insertions with the bone. It can be micro ruptures which can lead to a complete rupture or a cicatricial tendon with a fibrous nodule, it can be a peri-tendinous inflammation with a crepitant tendinitis or bursitis. These affections are known as abarticular pathologies.
Abarticular pathology concerns, therefore, serous bursae and tendons.

Two main aetiologies come under the collective peri-articular pathology:
- on the one hand, senescence,
- on the other, continual microtrauma: shock, friction, traction and over-exercising leading to tendinous fibre stress pathology,
- occasionally, a single shock or sudden traction trauma can be at fault. We must also take into account the effects of
– muscular hypertonia during prolonged exertion
– the cold and atmospheric conditions in general
– the causes of acidosis and local ischemia
– general and metabolic factors such as dehydration, electrolytic problems even the controversial role of hyperuricacidemia, or centres of infection well removed from the area.

Sporting technology leads to changes in mechanical axes and imposes extreme attitudes on articulations. However, responsibility usually lies with errors in the way training is conducted such as lack of limbering-up exercises or unsuitable equipment.

Tendinous abarticular pathology is recognised by:
- the progressive or sudden appearance of pain that goes away during limbering-up exercises and during rest periods, at least at the beginning of the pathology (pain at the beginning of the lesson, disappearing towards the end of the barre exercises and reappearing earlier and earlier during the lesson),
- clinical examination that reveals pain during palpation, thwarted active movement and passive stretching,
- additional examinations which allow the elimination of an osteo-articular affection or general illness. X-rays can show calcification or ossification and, thus, help with the diagnosis.