Rehabilitation of Tendon Problems in Patients with Diabetes Mellitus

Jonathan Rees, Jamie E Gaida, Karin Grävare Silbernagel, Johannes Zwerver, Joseph S Anthony, Alex Scott

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Exercise is crucial in the management of diabetes mellitus and its associated complications. However, individuals with diabetes have a heightened risk of musculoskeletal problems, including tendon pathologies. Diabetes has a significant impact on the function of tendons due to the accumulation of advanced glycation end-products in the load-bearing collagen. In addition, tendon vascularity and healing may be reduced due to diabetes-induced changes in the peripheral vascular system, and impaired synthesis of collagen and glycosaminoglycan. The current chapter presents an evidence-based discussion of considerations for the rehabilitation of tendon problems in people with diabetes. The following conditions are discussed in detail - calcific tendinopathy, tenosynovitis, tendon rupture, and non-calcifying tendinopathy. Common diabetes-related findings are presented, along with their potential impact on tendinopathy management and suggested modifications to standard tendinopathy treatment protocols. A holistic approach should be used to optimize musculotendinous function, including a comprehensive exercise prescription addressing strength, flexibility, and aerobic fitness.

Original languageEnglish
Pages (from-to)199-208
Number of pages10
JournalAdvances in Experimental Medicine and Biology
Publication statusPublished - 19 Aug 2016


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