Diabetes and the risk of Tendinopathy

It is (hopefully) widely known that Diabetes increases your risk of:

Cardiovascular disease.

Nerve damage (neuropathy)

Kidney damage (nephropathy)

Eye damage (retinopathy)

Foot damage.

Skin conditions

Hearing impairment.

Alzheimer's disease.

Sadly, some people are genetically pre-disposed to diabetes, whereas some people with mechanical imbalance, drugs, hormones and blood supply problems suffer diabetes. Yet is it widely known that obesity and diabetes are closely related.

In addition to the list above, people with Diabetes are at an increased risk of osteoporosis (brittle bone) and many musculo-skeletal conditions A new study by Yee Liu et al (2017) have investigated the new correlation between diabetes and tendinopathies. Particularly those of the shoulder and ankle or Achilles

The authors wanted to investigate whether this was a cause or effect. They identified with regards to shoulder or rotator cuff tendinopathy, there was a higher incidence in diabetes than non-diabetics. Poorly treated or untreated shoulder tendinopathies can lead to a frozen shoulder. This problem is exacerbated in those with diabetes. They also identified that people with diabetes have a higher incidence of shoulder calcification or osteoarthritis.

Similar could be said in the ankle. The authors identified a higher prevalence of Achilles Tendinopathy in diabetes compared to a similar control group without diabetes. Achilles Tendinopathy has been shown to have a higher blood glucose level

Treating Tendinopathies in diabetics

Currently, there is no firm evidence in the treatment of tendinopathies in diabetics. Some researchers believe a strict control of diabetes is key. Physically, a regime of stretching and strengthening of the associated structures is equally key, like any tendinopathy. However, the effectiveness in diabetics is not long-lasting which makes rehabilitation of tendinopathies in diabetics a challenge. The researchers identified that steroid injection and surgery are ineffective Tendons are subject to load and susceptible to increased loads. Diabetics tend to have an obesity problem. Potentially meaning this could be a double barreled problem. Diabetics may want to lose weight, but partaking in impact exercise could exacerbate an underlying tendinopathy.

People underestimate diabetes. People with diabetes and those who medically manage this are sometimes known to feel because they are on medication can still eat a poor diet. We need to understand just how nasty this disease is. It is now the single largest strain on the NHS and in the large part can be avoidable! Diet and exercise are the largest, effective controls of diabetes. People without diabetes know how painful tendinopathies are. I do, I have suffered both of these tendinopathies. But I can exercise, I go to the gym, I run and I eat a fairly healthy diet. Yet these tendinopathies are slow to recover. Add in diabetes, and the recovery is a lot harder. If you have a tendinopathy and suffer diabetes and would like more advice and support, then contact us or follow us on facebook.com/mikestampphysiotherapy