Tendinopathy

Tetive su vezivne strukture koje pasivno prenose snagu mišićne kontrakcije na kost i dnevno su izložene mehaničkom opterećenju. Građene su od tenocita uloženih u ekstracelularni matriks u kojem kolagena vlakna tip I održavaju čvrstoću strukture. Istezanje kolagenih vlakana za više od 10% izvorne duljine može izazvati njihovo pucanje. U razvoju degenerativne kronične tendinopatije preklapaju se reaktivna akutna tendinopatija, poremećaj reparacije i degenerativna tendinopatija. Akutno stanje zahtijeva rasterećenje prvih dana, a u kroničnoj fazi preporuča se vježbanje preko granice boli. Zadaća kliničara je razlikovati reverzibilno od ireverzibilnog stanja i iskoristiti preostali reparacijski potencijal ili planirati kirurške metode liječenja.Tendons are made of connective tissue and passively transfer force from muscle contraction to the bone and are daily exposed to mechanical loading. They are built of tenocytes inserted in the extracellular matrix in which collagen type I fibers maintain its strength. Stretching the collagen fibers of more than 10% of the original length can cause them to crack. In the development of chronic degenerative tendinopathy there is overlapping of reactive acute tendinopathy, tendon dysrepair (failed healing) and degenerative tendinopathy. Acute condition requires unloading in the first few days and in the chronic phase, it is recommended to exercise even over the limit of pain. The role of clinician is to distinguish reversible from irreversible condition and utilize the remaining reparations potential or to consider surgical treatment methods