Dominic Stone
Tendon injuries are very common, with 50% of musculoskeletal injuries in the US involving tendons. Tendon repair surgery is often required to fix a torn or damaged tendon, and recovery can take up to 12 weeks. The surgery involves making an incision to locate the ends of the tendon and stitch them together. The patient is given an anaesthetic to prevent pain during the procedure. In some cases, a tendon graft or transfer may be required. There are risks associated with surgery, including infection and further tendon snapping or sticking to nearby tissue. Researchers are currently working on developing new treatments for tendon injuries, such as using stem cells to repair tendons.
| Characteristics | Values |
|---|---|
| Tendon function | Transmit contractile forces from muscle to bone |
| Tendon composition | Tough, stretchy, fibrous tissue |
| Tendon injury causes | Laceration, contact sports injuries, chronic tendinopathy, acute tendon rupture, age, diseases (gout, hyperparathyroidism), steroid injections, type O blood |
| Tendon injury symptoms | Weakness, pain, inability to move the injured area, inability to bear weight, deformity of the area |
| Tendon repair surgery | Bring back normal range of motion and function to an injured tendon |
| Tendon repair surgery procedure | Make a cut through the skin, remove damaged tissue, sew torn ends together, sew skin back together, cover with dressings and splint |
| Tendon repair surgery anesthesia | Local, regional, general |
| Tendon repair surgery recovery | Up to 12 weeks, physical therapy recommended, hand exercises for hand tendon repair |
| Tendon repair surgery risks | Infection, tendon snapping or sticking to nearby tissue |
| Tendon repair alternatives | Tendon graft, tendon transfer, stem cell therapy |
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What You'll Learn
Surgical treatment
During the procedure, the surgeon will make an incision over the injured tendon to assess the damage and remove any dead or damaged tissue. If the tendon has been torn, the surgeon will carefully sew the ends back together. In some cases, a tendon graft may be necessary if there is not enough healthy tendon to reconnect. This involves taking a piece of tendon from another part of the body, such as the foot or toe, or using an artificial tendon. If the tendon has detached from the surrounding tissue, the surgeon will reattach it. Once the repair is complete, the wound is closed with stitches and covered with a dressing.
After tendon repair surgery, the patient may be asked to wear a sling or splint to immobilize the joint and reduce tension on the tendon during the healing process. Physical therapy is usually recommended to help restore movement and prevent the formation of excessive scar tissue. The recovery process can take up to 12 weeks, and successful recovery depends on following the instructions provided by the healthcare provider.
Surgical repair of tendons can vary depending on the location and severity of the injury. For example, in the case of a ruptured biceps tendon, surgery is more commonly performed on distal biceps ruptures than proximal biceps tears. Additionally, surgery may be considered for middle-aged individuals who require full supination strength for their work.
In some cases, tendon repair surgery may be performed as part of a more complex procedure, such as a vascularized neuromuscular transfer or tendon transfer surgery. These procedures aim to restore functional movement following muscular or neurological injuries or diseases. The optimum tension at which a muscle should be set following tendon repair is still being studied, and surgeons rely on their experience and observations to guide the repair process.
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Recovery process
The recovery process for muscle tendon repair is a multifaceted and often lengthy procedure, requiring physical therapy and, in some cases, surgery. Tendon injuries are exceedingly common, with 50% of musculoskeletal injuries involving tendons or ligaments. The road to recovery can be challenging, but with proper care and time, most patients can expect to regain normal function.
The first step in the recovery process is to seek medical attention. A doctor will assess the injury and determine the best course of treatment. This may include surgery, which can be performed in several ways depending on the location and severity of the injury. For example, arthroscopic surgery is less invasive than open surgery, and patients may recover slightly faster. During tendon repair surgery, the surgeon will make incisions to access the injured tendon, remove any damaged tissue, and carefully sew the tendon back together. The type of anaesthesia used during surgery will depend on various factors, and patients should discuss potential outcomes and risks with their doctor beforehand.
Following surgery, patients can expect a minimum of several weeks of healing time. The affected area may need to be immobilised or protected, and a splint or cast may be used to reduce tension and support the tendon as it heals. It is crucial to follow the surgeon's instructions during this time to avoid re-injury. Returning to daily activities and sports or high-impact activities will generally take longer and require specific clearance.
Physical therapy plays a vital role in the recovery process. It helps regain the range of motion, strengthen the repaired tendon and surrounding muscles, and gradually return to functional activities. Active participation in post-operative physical therapy is crucial for optimal recovery. Specific exercises, such as cardiovascular exercises and daily low-impact activities, can expedite recovery and improve the range of motion in the affected area.
Overall, the recovery process for muscle tendon repair can be challenging and time-consuming, but with proper medical care, physical therapy, and time to heal, most patients can expect to regain normal function and return to their daily activities.
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Healing and repair mechanisms
Tendon injuries are exceedingly common, with 50% of musculoskeletal injuries involving tendons or ligaments. Tendons are the soft, band-like tissues that connect muscles to bone. They are responsible for transferring weight and allowing the body to move.
Tendon injuries can occur anywhere in the body where there are tendons, with the most common areas being the shoulders, elbows, ankles, knees, and fingers. The tendons in these areas are particularly vulnerable to injury due to their location and function. For example, the rotator cuff tendons in the shoulder are composed of four muscles that function together to raise the arm and keep the shoulder stable. Similarly, the Achilles tendon, located at the back of the foot, is crucial for standing on tiptoes and pushing off when starting to run.
Tendon injuries can range from chronic tendinopathy to acute tendon rupture. When a tendon is damaged, movement may be seriously limited, and the affected area may feel weak or painful. The healing process for tendons occurs in three overlapping steps: inflammation, proliferation, and remodelling. Each step has tendon-specific durations, and the repair process can be supported by immobilization and physical therapy.
Surgical treatment is often required for tendon injuries, especially in the case of deep cuts or tears. The goals of tendon repair surgery are to restore normal range of motion and function to the injured tendon. During surgery, the surgeon will make an incision to locate the ends of the divided tendon and carefully stitch them together. If there is not enough healthy tendon to reconnect, a tendon graft or transfer may be performed.
There are risks associated with tendon repair surgery, including infection and the potential for the repaired tendon to snap or stick to nearby tissue. A lengthy recovery period is also required, typically lasting up to 12 weeks. During this time, the patient may need to wear a splint or cast to support the repaired tendon and reduce tension. Physical therapy is usually necessary to restore movement safely and minimize scar tissue formation.
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Causes of tendon injuries
Tendon injuries are exceedingly common, with 50% of musculoskeletal injuries in the United States involving tendon or ligament injuries. Tendons are fibrous bands of tissue that connect muscles to bones. They are essential for movement and transferring weight, as well as protecting joints from damage. Extensor tendons, for example, work by stretching when a part of the body needs to move outward, such as when standing on the toes or straightening the fingers.
There are several causes of tendon injuries, which can be acute or develop over time due to overuse. Acute tendon injuries are one-time events that strain the tendon, leading to a tear or rupture. Examples include Achilles tendon ruptures, which often occur during sports involving running or jumping, patellar tendon tears in the knee, and rotator cuff tears in the shoulder. These injuries can happen to anyone, especially those who engage in a lot of repetitive movements as part of their jobs, exercise routines, or sports.
Overuse injuries, on the other hand, develop gradually due to repeated micro-traumas or chronic degenerative changes. This can result in conditions like tendonitis, tendinosis, tenosynovitis, paratenonitis, and tendinopathy. Tendonitis refers to acute inflammation typically caused by a small tear from a sudden injury or repeated micro-traumas. Tendinosis, which often develops from chronic tendonitis, is a non-inflammatory degeneration of the tendon that leads to structural changes. Tenosynovitis and paratenonitis refer to inflammation of the synovial sheath and paratenon, respectively, which are protective coverings around certain tendons. Tendinopathy involves chronic degenerative changes that contribute to a tendon rupture.
Additionally, aging is a factor that increases the vulnerability to tendon injuries. Aging decreases tenoblast volume and plasmalemmal surface density, affecting collagen production and increasing stiffness in the tendons. This impedes the tendon's capacity to withstand loading, making it more susceptible to injury.
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Prevention of tendon injuries
Tendon injuries are exceedingly common, with 50% of musculoskeletal injuries recorded in the United States involving tendon or ligament injury. Tendons are tough, stretchy tissues that join muscles to bones, allowing the body to move and transfer weight. They also help protect joints from damage.
- Warm up and stretch before any physical activity to prevent sudden injury.
- Exercise regularly to strengthen the muscles around the joints.
- When beginning new activities or exercise routines, start slowly and gradually increase the intensity.
- Ensure your body is correctly positioned when performing daily tasks.
- Take frequent breaks from repetitive exercises and motions.
- Avoid activities that cause pain.
- Use padding, gloves, or grip tape to cushion joints when using tools and sports equipment.
- Keep objects like your phone or important papers close by, so you don't have to reach out constantly.
- If an object is out of reach, stand up to retrieve it instead of reaching while sitting.
- Adjust your chair so that your knees and hips are at the same level.
- Avoid sitting in the same position for more than 30 minutes.
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Frequently asked questions
A tendon is a tough, stretchy fibrous tissue that connects muscle to bone. It stores, releases, and dissipates energy to transmit contractile forces from muscle to bone, allowing the body to move and transfer weight.
Tendon injuries are exceedingly common, with 50% of musculoskeletal injuries in the United States involving tendon or ligament injury. The most common tendon injuries are tears to the Achilles tendon in the ankle, injury to the rotator cuff in the shoulder, or damage to the tendons surrounding the kneecap. Tendon injuries can also be caused by contact sports injuries such as football, wrestling, and rugby.
Tendon repair is usually done through surgery to fix a torn or damaged tendon. The surgeon makes an incision to locate the ends of the tendon and stitch them together. If there isn't enough healthy tendon, a tendon graft or transfer may be performed. Recovery can take up to 12 weeks, and physical therapy is often necessary to restore movement safely.
