Tendon Degenerations

What is it?

Tendons are fibrous structures that connect muscles to bones. They are poorly vascularised structures with low oxygen consumption and therefore their regeneration is rather slow. Violent traumatic events, repetitive micro-traumas or functional overload over time can damage their structure. Injuries to tendons, if not healed properly, can lead to severe inflammation characterised by pain and a significant reduction in mobility. The most susceptible sites are the shoulder, knee, elbow and foot. Jumper's Knee is a condition resulting from frequent or repetitive trauma to the patellar tendon just below the knee. Epicondylitis or tennis elbow and epitrocleitis (golfer's elbow) is a condition caused by repetitive movements of the forearm, such as those required in sports such as tennis, golf, weightlifting and even some jobs. These activities can cause microfractures in the tendon, resulting in chronic pain and difficulty in movement. Achilles tendinopathy, the Achilles tendon is the longest tendon anatomically connecting the heel bone to the calf muscles and is subjected to high stress that can damage it.  Finally, we talk about rotator cuff tendinopathy when it affects the shoulder joint. This joint is characterised by a shallow spherical morphology whose strength and stability is provided by the rotator cuff. Injuries and repetitive strain can cause damage to the tendons that make up the cuff.

Which are the symptoms?

Clinically, tendon injuries are manifested by sharp pain, functional impotence, haematoma and swelling.

·         pain (increased with movement)

·         swelling

·         sensation of warmth

·         stiffness (more at night and in the morning)

·         redness

·         creaking when moving

·         bruising

How is it diagnosed?

The clinical examination is necessary to identify and determine the severity of the tendon injury. This stage includes an initial interview with the patient (symptoms, medical history) and a second stage where the actual examination takes place. The specialist will examine the affected area to detect any deformity, swelling, bruising and changes in mobility. Palpation is used to check for pain. The neurological and vascular aspect of areas distal to the injured area will also be examined. Imaging techniques such as ultrasound and magnetic resonance imaging are also often used. The use of imaging is intended to confirm the results of the clinical examination.

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How is it treated?

The human body is capable of spontaneous healing through normal tissue healing processes involving growth factors and cellular elements with a regenerative function. When these processes fail, it is possible to resort to advanced technologies that "mimic" the physiological processes of healing. Regenerative medicine is an interdisciplinary field that combines research and the clinic and uses the therapeutic potential of the body to promote regeneration and restore the physiological condition of tissues affected by disease, injury and aging. The difference between regenerative medicine and, for example, transplantation or substitution medicine is that the goal is not to replace what can no longer function in the human body, but to provide the necessary elements to stimulate and support the disturbed normal healing processes of the body. This is made possible through the use of therapeutic agents that are normally already present in the human body, such as platelet-derived growth factors (PRP) and mesenchymal cells derived from bone marrow and adipose tissue (MSC).

RE.GA.IN is a center of excellence that provides a clinical platform to ensure the best possible experience in regenerative medicine. Patients' data are collected over a long period of time using the most modern standard operating procedure and then identify the most performing treatment for a given indication. RE.GA.IN treats the patients only with selected medical devices, paying attention to their scientific quality and safety profile. RE.GA.IN's activities are supported by the Research Laboratories of the Galeazzi Research Hospital to ensure a full characterization of the biological products produced in a custom manner for each patient.

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