Causes of Tendon Surgery

Introduction

Tendons are thick, strong cords of tissue that attach muscles to bones, playing an essential role in enabling smooth and coordinated body movements. Every action whether it’s walking, lifting, typing, or throwing a ball relies on tendons. But despite their strength, tendons are not immune to damage. Over time or due to sudden trauma, they can suffer from wear, tear, inflammation, or rupture, which can severely limit movement and cause intense pain.

While many tendon problems can be managed with rest, physical therapy, or medication, some cases require surgical intervention to restore proper function. Tendon surgery is performed when conservative treatments fail, or when the tendon is too severely damaged to heal on its own. It may involve repairing a torn tendon, removing scar tissue, or replacing a damaged tendon with a graft.

Understanding what leads to tendon surgery is important for both prevention and timely treatment. In this blog, we explore the main causes of tendon surgery, shedding light on the underlying conditions and risk factors that make surgery necessary.

Causes of Tendon Surgery

1. Acute Tendon Injuries :- One of the most common reasons for tendon surgery is an acute injury. This type of damage typically happens suddenly due to trauma or a forceful movement. For example, athletes often experience torn tendons during high-intensity activities like sprinting, jumping, or heavy lifting. A tendon can also rupture from a deep cut or a fall, especially in older adults with weakened tissue. When a tendon is completely torn or severed, it cannot heal properly without surgical repair. Tendons like the Achilles, rotator cuff, and biceps are particularly prone to acute injuries. Surgery is often needed to reattach the torn ends and restore muscle function, especially if the injury results in a complete loss of strength or mobility.

2. Chronic Tendonitis :- Chronic tendonitis, also called tendinopathy, is another major cause of tendon surgery. It develops gradually over time due to repeated strain or overuse of a tendon. The condition is marked by inflammation, microtears, and degeneration of tendon fibers. While early stages may respond well to rest and physical therapy, long-term tendonitis can lead to permanent damage. In cases where the tendon becomes thickened, stiff, or painful despite non-surgical treatments, surgery may be required. This usually involves removing inflamed tissue, smoothing out damaged areas, and stimulating healing. Chronic tendonitis is frequently seen in people with repetitive-motion jobs, athletes, or those who do not allow adequate recovery time between physical activities.

3. Degenerative Conditions Due to Aging :- As we age, our tendons lose elasticity and become more prone to wear and tear. Reduced blood flow, accumulated microtrauma, and decreased collagen production all contribute to tendon degeneration. This natural aging process weakens tendons, making them more vulnerable to tears, inflammation, and rupture even with minimal strain. For older adults experiencing tendon-related issues that significantly impact daily life, surgery might be the best option. Degenerative tendon conditions like rotator cuff tears in the shoulder are often addressed surgically in patients over 50, especially when pain and loss of function persist for months.

4. Inflammatory Diseases :- Certain autoimmune and inflammatory diseases can attack tendons and their surrounding structures. Conditions such as rheumatoid arthritis, lupus, and gout can cause chronic inflammation, weakening the tendon over time. In these cases, the body’s immune system mistakenly attacks its own tissues, leading to tendon swelling, pain, and damage. When the inflammation is not adequately controlled with medication, it may cause tendon rupture or deformity that necessitates surgery. Tendon surgery in patients with autoimmune diseases may involve cleaning the affected area, repairing damaged tendons, or releasing tight tissues to restore mobility.

5. Repetitive Stress and Overuse :- Overuse injuries are another frequent cause of tendon surgery. These occur when a tendon is subjected to repetitive motion without sufficient rest, leading to cumulative microtears and eventual breakdown. Activities like typing, playing musical instruments, or factory work can put stress on the same tendons for hours each day. Conditions such as tennis elbow (lateral epicondylitis), De Quervain’s tenosynovitis, and trigger finger are examples of overuse-related tendon problems. In severe or long-standing cases, surgery becomes necessary to release the tendon sheath, remove scar tissue, or repair damaged tendon fibers.

6. Tendon Contracture or Tightening :- Tendon contracture refers to a condition where tendons and muscles shorten or tighten abnormally, limiting the range of motion. This may happen due to neurological disorders like cerebral palsy or stroke, traumatic injury, or prolonged immobility. In these cases, tendon surgery is often performed to release the contracted tendon or lengthen it, allowing the joint to move more freely. Tendon release or tendon lengthening surgeries are especially helpful for improving quality of life in patients who struggle with joint stiffness or abnormal limb positioning due to contractures.

7. Failed Previous Tendon Surgery  :- Sometimes, patients undergo tendon surgery but do not experience satisfactory results due to complications like re-tearing, poor healing, or excessive scar tissue. In such cases, revision surgery may be required to correct the previous issue and improve tendon function. These procedures can be complex and may involve tendon grafting, transfer, or reconstruction. Failed surgeries often arise from improper rehabilitation, infection, poor surgical technique, or underlying health problems that impair healing.

8. Nerve Damage Affecting Tendon Function :- Tendons may function poorly or become non-functional if the nerve controlling them is damaged. For instance, in brachial plexus injuries or spinal cord trauma, certain muscle groups lose movement due to nerve injury, even though the tendons themselves are intact. Tendon transfer surgery is often the answer in such cases. Surgeons reroute a healthy, functioning tendon to take over the lost movement of a paralyzed one. This cause of tendon surgery is especially relevant for patients with partial paralysis or permanent nerve damage.

Conclusion

Tendon surgery is often the last resort after conservative treatments fail, but in many cases, it becomes essential for restoring mobility, reducing pain, and preventing further complications. The causes leading to tendon surgery are diverse—ranging from acute injuries and repetitive stress to age-related degeneration and chronic diseases. By recognizing the warning signs early and understanding what leads to surgical intervention, patients can make informed decisions about their care and improve their chances of recovery.

Whether caused by trauma, aging, or underlying medical conditions, tendon issues should never be ignored. With timely diagnosis, proper treatment, and when necessary, expert surgical intervention, individuals can regain strength, flexibility, and the ability to lead an active, pain-free life.