Jaap Wonders
Physical therapists and other therapists often treat patients with tendinopathy, which is a condition that occurs frequently and has poor prognosis and long recovery time. Multiple lifestyle factors have found to be risk factors for tendinopathy. Lifestyle factors such as exercise and movement, nutrition, sleep and psychosocial factors are often interrelated and can create a vicious spiral for patients with tendinopathy. Unhealthy lifestyle factors can cause chronic pain, low-grade inflammation, elevated adiposity, higher waist-to-rib ratio, greater body mass index, overweight, obesity, high cholesterol, metabolic syndrome, diabetes type II, rheumatoid arthritis and inflammatory-related diseases, which are the main factors explaining the association between lifestyle factors and tendinopathy. Single or multiple lifestyle interventions are available for the treatment of patients with tendinopathy. Both exercise and movement and nutritional interventions tend to improve tendon health and recovery of tendinopathy indirectly by decreasing adiposity, weight, diabetic symptoms, low-grade inflammation and pain. They are also likely to improve blood levels, bone and muscle health, and collagen synthesis of tendons, tendon function and tendon-related pain. Sleep, psychological factors, smoking behaviour and alcohol use also affect tendon pain and tissue healing. Physical therapists and other therapists may incorporate interventions as part of the treatment of tendinopathy targeted at improving sleep and psychosocial factors. Smoking behaviour and alcohol use should be discouraged, for which multiple interventions are available. The purpose of this commentary article is to inform physical therapists and other therapists about lifestyle factors as risk factors and treatment options in tendinopathy.
