Figure 3.

Schematic representation of tendinopathy pathogenesis. It is hypothesized that various risk factors including mechanical overuse as well as intrinsic and extrinsic factors can trigger the development of tendinopathy in a continuous way. The first step is that these risk factors impair proper tendon repair leading to early reactive tendinopathy, which still harbors the capacity for healing. Furthermore, accumulation and increase of risk factors lead to tendon disrepair, that subsequently results in tendon degeneratione. Poor function and load capacity of the tendon finally end up in the end-state of tendinopathy, that leads to tendon tearing or rupture. Based on Cook and Purdam [11] and Shearn et al. [89].