Main Causes of Tendon Injuries

1. Overuse and Repetitive Movement

• One of the most common causes of tendon injuries is repeated stress.
• When the same movement is performed again and again, the tendon may experience repeated loading. If adequate recovery is not allowed, the tissue may become irritated or develop small areas of damage.

Examples include:

• Repeated lifting
• Frequent gripping
• Typing or computer work
• Repetitive wrist movements
• Throwing
• Running
• Jumping
• Repeated overhead activities

Jobs and hobbies involving repetitive movements can therefore place additional stress on particular tendons.

2. Sudden Increase in Physical Activity

• Increasing exercise intensity too quickly is another important factor.
• Someone who suddenly increases running distance, lifting weight, training frequency, or sports intensity may place more load on a tendon than it is prepared to handle.
• For example, a person who has not exercised for several months and suddenly begins intense running may put excessive stress on the Achilles tendon.
• Gradual progression gives muscles and tendons more time to adapt to increased demands. Mayo Clinic specifically identifies sudden increases in training amount or difficulty as a risk factor for tendinopathy and tendon problems.

3. Sports Injuries

• Sports can expose tendons to sudden and repetitive forces.
• Activities involving running, jumping, throwing, rapid changes in direction, or repeated overhead movements may increase tendon loading.

Sports-related tendon injuries can occur through:

• Sudden acceleration
• Jumping and landing
• Rapid changes of direction
• Forceful throwing
• Repeated overhead movement
• Direct trauma
• Overtraining

Achilles tendon ruptures, for example, are commonly associated with sports involving running, jumping, sudden starts, and changes in direction.

4. Sudden Trauma

• Not all tendon injuries develop gradually.
• A fall, road accident, unexpected movement, or direct impact can place sudden force on a tendon. If the force exceeds the tendon’s capacity, the tissue may partially or completely tear.

Sudden trauma can also cause injuries to nearby structures such as:

• Muscles
• Ligaments
• Bones
• Nerves
• Blood vessels
• Skin

This is particularly important when the injury involves the hand or wrist.

5. Deep Cuts and Lacerations

• Deep cuts are important causes of tendon injuries, particularly in the hand and fingers.
• A sharp object can pass through the skin and damage an underlying tendon. Depending on the location and depth of the wound, nerves, blood vessels, and other structures may also be affected.
• A person with a tendon injury caused by a cut may notice difficulty bending or straightening a finger.
• Such injuries require professional assessment rather than repeated movement testing at home.

6. Crush Injuries

A crush injury can damage tendons through direct compression or severe trauma.

These injuries may occur during:

• Workplace accidents
• Machinery-related incidents
• Falls
• Road traffic accidents
• Heavy objects falling on a limb

Crush injuries can be complex because several tissues may be affected at the same time.

7. Age-Related Changes

• Age is another factor associated with tendon problems.
• As people age, tendons can become less flexible and may take longer to recover from physical stress. This can make certain tendons more susceptible to injury.
• Age does not mean that tendon injury is unavoidable. However, training progression, adequate recovery, appropriate technique, and sensible activity levels become increasingly important.

8. Poor Exercise Technique

Incorrect technique can increase the amount of stress placed on a tendon.

This may occur during:

• Weightlifting
• Running
• Tennis
• Throwing
• Jumping exercises
• Gym workouts
• Manual work

Poor technique can cause forces to be distributed inefficiently, increasing the load on particular tissues.Correct technique is particularly important when an activity involves repetitive movement.

9. Insufficient Recovery

• Tendons need time to adapt and recover from repeated loading.
• Training intensely without adequate rest can contribute to overuse problems. Returning to demanding activity too quickly after an injury can also place unnecessary stress on a healing tendon.

Recovery should take into account:

• Training intensity
• Previous injury
• Sleep
• Physical workload
• Exercise frequency
• Rehabilitation progress

A sudden return to the same activity level after a period of inactivity may also increase injury risk.

10. Poor Equipment or Footwear

• Equipment can influence the amount of stress placed on certain tendons.
• For example, inappropriate or poorly supportive footwear may contribute to excessive loading during running or other activities. Hard training surfaces can also increase physical demands.
• Mayo Clinic identifies poor equipment and hard surfaces among factors that may increase the risk of tendinopathy, particularly during physical activity.