Tendinopathy: Types, Epidemiology, Molecular Mechanisms, and Future Precision‐Oriented Therapeutic Strategies
4 affiliations
- 1Department of Sports Medicine Beijing Key Laboratory of Sports Injuries Peking University Third Hospital Beijing China.
- 2Institute of Sports Medicine of Peking University Beijing China.
- 3Engineering Research Center of Sports Trauma Treatment Technology and Devices in Ministry of Education Beijing China.
- 4Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital Beijing China.
Abstract
Tendinopathy represents a heterogeneous spectrum of tendon disorders characterized by persistent pain, impaired function, and progressive disruption of tissue homeostasis. Rather than a single degenerative entity, tendinopathy reflects the interaction between mechanical adaptation failure, immune dysregulation, extracellular matrix remodeling, and systemic metabolic influences. However, its pathophysiological mechanisms remain incompletely understood. Tendinopathy can affect multiple anatomical sites, such as the rotator cuff, Achilles tendon, and patellar tendon, and has a high prevalence in both the general population and athletes. Despite decades of research, there is currently a lack of targeted therapies capable of effectively reversing the pathological process, and clinical management is primarily limited to empirical symptomatic treatment. This review systematically synthesizes the epidemiology and risk factors of tendinopathy and proposes a "multidimensional tendinopathy remodeling network" model encompassing mechanotransduction, inflammatory cascades, pathological angiogenesis, and matrix turnover. Furthermore, we discuss emerging approaches for molecular stratification through multimodal imaging and biomarkers, and evaluate precision-oriented therapeutic strategies, including mechanomodulation, immunomodulation, regenerative medicine, and nano delivery systems. This framework provides a conceptual foundation for understanding the heterogeneity of tendinopathies and facilitates a shift from symptom-oriented treatment to mechanism-oriented approaches, potentially leading to precision treatment strategies. At the same time, it highlights the challenges in current translational research and points to future research directions for personalized tendon repair strategies.
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BibTeX
@article{wu2026tendinopathy,
title = {{Tendinopathy: Types, Epidemiology, Molecular Mechanisms, and Future Precision‐Oriented Therapeutic Strategies}},
author = {Yang Wu and Junyi Long and Meng Yang and Hongjie Huang and Jianquan Wang},
journal = {MedComm},
year = {2026},
month = oct,
doi = {10.1002/mco2.71098},
url = {https://europepmc.org/article/PMC/PMC13717297},
note = {CC BY},
}
RIS
TY - JOUR
TI - Tendinopathy: Types, Epidemiology, Molecular Mechanisms, and Future Precision‐Oriented Therapeutic Strategies
AU - Yang Wu
AU - Junyi Long
AU - Meng Yang
AU - Hongjie Huang
AU - Jianquan Wang
PY - 2026
DA - 2026/10/29
JO - MedComm
DO - 10.1002/mco2.71098
UR - https://europepmc.org/article/PMC/PMC13717297
AB - Tendinopathy represents a heterogeneous spectrum of tendon disorders characterized by persistent pain, impaired function, and progressive disruption of tissue homeostasis. Rather than a single degenerative entity, tendinopathy reflects the interaction between mechanical adaptation failure, immune dysregulation, extracellular matrix remodeling, and systemic metabolic influences. However, its pathophysiological mechanisms remain incompletely understood. Tendinopathy can affect multiple anatomical sites, such as the rotator cuff, Achilles tendon, and patellar tendon, and has a high prevalence in both the general population and athletes. Despite decades of research, there is currently a lack of targeted therapies capable of effectively reversing the pathological process, and clinical management is primarily limited to empirical symptomatic treatment. This review systematically synthesizes the epidemiology and risk factors of tendinopathy and proposes a "multidimensional tendinopathy remodeling network" model encompassing mechanotransduction, inflammatory cascades, pathological angiogenesis, and matrix turnover. Furthermore, we discuss emerging approaches for molecular stratification through multimodal imaging and biomarkers, and evaluate precision-oriented therapeutic strategies, including mechanomodulation, immunomodulation, regenerative medicine, and nano delivery systems. This framework provides a conceptual foundation for understanding the heterogeneity of tendinopathies and facilitates a shift from symptom-oriented treatment to mechanism-oriented approaches, potentially leading to precision treatment strategies. At the same time, it highlights the challenges in current translational research and points to future research directions for personalized tendon repair strategies.
SN - 2688-2663
ER -