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  • Chronic tendinopathies and ligament disorders are pathologic conditions of tendons or ligaments, resulting mainly from repeated minor strain. Formerly called \'tendonitis\' or \'ligamentitis\'. Etiologic factors: degenerative processes are thought to be principal underlying pathology; repeated minor strain is considered to be main precipitating factor; drug-associated forms have been described; an understanding of the pathophysiology continues to evolve. Most commonly injured tendons and ligaments: supraspinatus tendon and long head of the biceps muscle; Medial and lateral extensors of the elbow; patellar tendon; Achilles tendon; posterior tibialis tendon. Intrinsic and extrinsic risk factors: overuse (sports activities, training errors, fatigue); cold environment during outdoor training; faulty footwear/equipment; drugs (e.g., fluoroquinolone antibiotics, oral contraceptives, injected corticosteroids and statins). Commonly described presenting symptoms: pain at the site of the affected tendon or ligament; morning stiffness, local tenderness, swelling and reduced articular range of motion. Therapeutic approaches include: exercise, shock wave therapy, growth factors, nitric oxide, sclerosant therapy, gene therapy, and tissue engineering.
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