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Upper Limb and Hand Pathology

Tendinopathies

OVERVIEW

Tendinopathies, commonly referred to as tendon disorders, are conditions that affect the tendons, the tough bands of tissue that connect muscles to bones. Tendinopathies can develop in any tendon in the body, but they most commonly affect those around the shoulders, elbows, wrists, knees, and ankles.

Types of tendinopathies

Dr du Plessis   manages a range of tendinopathies that individuals may encounter. These include:

  1. Tennis elbow (lateral epicondylitis): A condition affecting the outer part of the elbow, often associated with repetitive arm motion.
  2. Golfer's elbow (medial epicondylitis): Similar to tennis elbow but affecting the inner part of the elbow.
  3. Achilles tendinopathy: Inflammation or degeneration of the Achilles tendon, commonly seen in runners and athletes.
  4. Rotator cuff tendinopathy: Affecting the tendons of the shoulder, often causing pain and limited range of motion.
  5. Patellar tendinopathy: Commonly known as jumper's knee, it involves inflammation or degeneration of the patellar tendon below the kneecap.
  6. De Quervain's tenosynovitis: A condition affecting the tendons on the thumb side of the wrist, leading to pain and swelling.

Causes

Understanding the causes is crucial for effective treatment. Tendinopathies often result from a combination of factors, including:

  1. Overuse: Repetitive movements and excessive strain on a tendon without adequate rest.
  2. Age: Tendons naturally weaken and become less flexible with age, increasing the risk of injury.
  3. Poor posture and biomechanics: Incorrect body mechanics during activities can contribute to tendon stress.
  4. Injury: Direct trauma or sudden, forceful movements can damage tendons.
  5. Medical conditions: Conditions such as rheumatoid arthritis and diabetes can increase the risk of tendinopathies.
SYMPTOMS
Dr du Plessis emphasises the importance of recognising tendinopathy symptoms, including:
  • Pain: Tenderness and pain, often worsening with movement or activity.
  • Swelling: Inflammation around the affected tendon.
  • Stiffness: Reduced range of motion in the affected joint.
  • Weakness: Difficulty in using the affected muscle or joint.
TREATMENT
Dr du Plessis employs a comprehensive approach to treat tendinopathies:
Conservative treatment:
  • Rest and activity modification: Allowing the tendon to heal by avoiding activities that exacerbate the condition.
  • Physical therapy: Strengthening exercises and stretching to improve tendon flexibility and strength.
  • Ice and heat therapy: Managing inflammation and promoting blood flow.
  • Injectables: Platelet-Rich-Plasma and Collagen injections can be employed in certain appropriate cases.
SURGERY
  • When conservative measures are insufficient, Dr du Plessis may recommend surgical intervention.
  • Procedures may include tendon release, debridement, or, in severe cases, tendon transfer.

FAQ

How long does recovery take for tendinopathies?
Recovery times vary based on the severity of the tendinopathy and the chosen treatment. Conservative measures may require weeks to months, while surgical recovery timelines depend on the specific procedure.
Can tendinopathies be prevented?
Prevention strategies include proper warm-up before physical activity, maintaining good posture and biomechanics, and incorporating strength and flexibility exercises into your routine.
How are tendinopathies diagnosed?
Orthopaedic specialists like Dr Jason du Plessis diagnose tendinopathies through a combination of physical examinations, medical history reviews, and imaging studies such as X-rays or MRI scans.

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    PUBLICATIONS

    Assessment of the Reliability and Reproducibility of the Langenskiöld
    Classification in Blount’s Disease

    DU PLESSIS J, Firth GB, Robertson A. Assessment of the reliability and reproducibility of the Langenskiöld classification in Blount's disease. Journal of Pediatric orthopedics. Part B. 2019 Nov 12.

     

    The Impact of the COVID-19 lockdown restrictions on orthopaedic trauma admissions in a central academic hospital in Johannesburg

    Foster M, Du Plessis J, Jansen van Vuuren M, Jingo M, Pietrzak JR. The impact of the COVID-19 lockdown restrictions on orthopaedic trauma admissions in a central academic hospital in Johannesburg. SA Orthopaedic Journal. 2022;21(2):70-5.

    Short term results following two stage revision for periprosthetic joint infection

    DU PLESSIS, J et al. Short-term results following two-stage revision for periprosthetic joint infection. South African Orthopaedic Journal, [S.l.], v. 19, n. 2, p. 64-69, may 2020

     

    Comparison of visual estimations of distal radius fracture radiographic parameters between different levels of orthopaedic doctors.

    Naidoo V, Milner B, du Plessis J. SA Orthop J. 2025;24(1):26-31. http://dx.doi.org/10.17159/2309-8309/2025/v24n1a4