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Pathophysiology of Tendinopathy: Implications for Tennis Elbow

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Tennis Medicine

Abstract

Targeted therapies of elbow tendinopathies have been limited due to lack of knowledge of the underlying pathophysiology. Recreational tennis players are mostly affected by the classical “tennis elbow”––humeral epicondylar lateral tendinopathy, while elite tennis players more commonly present with medial humeral epicondylar tendinopathy, reflecting differences in loading. Repetitive loading in combination with newly discovered intrinsic risk factors, such as genetic abnormalities of eg. matrix proteins and metabolic disorders lead to neuronal dysregulation and the development of tendinopathy. Aberrant sensory nerve sprouting in the tendon may cause pain and by constant release of mediators produce fibrosis. Targeted therapies should in a holistic way address loading abnormalities and intrinsic risk factors with eccentric exercise as a cornerstone of treatment.

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Authors and Affiliations

  1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

    Per Renstrom & Paul W. Ackermann

  2. Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden

    Per Renstrom

  3. Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden

    Paul W. Ackermann

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  1. Per Renstrom
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Correspondence to Paul W. Ackermann .

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Editors and Affiliations

  1. Dept of Orthopaedics and Trauma, Concordia Hospital, Rome, Italy

    Giovanni Di Giacomo

  2. ATP World Tour, Rehab Plus Sports Therapy Scottsdale, Scottsdale, AZ, USA

    Todd S. Ellenbecker

  3. Lexington Clinic Orthopedics, Lexington, KY, USA

    W. Ben Kibler

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Renstrom, P., Ackermann, P.W. (2018). Pathophysiology of Tendinopathy: Implications for Tennis Elbow. In: Di Giacomo, G., Ellenbecker, T., Kibler, W. (eds) Tennis Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-71498-1_18

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