Does High Cholesterol Play a Role in Tendinopathy?

Tendons are the tough fibers that connect your muscles to bones. When pain or abnormality occurs in the tendons, it is referred to as tendinopathy. Whilst its exact cause is unknown, it is often associated with overuse. However, there is another theory that tendinopathy is associated with blood fats, such as cholesterol and triglycerides, which cause a certain level of inflammation that interferes with the structure of tendons.

Interestingly, a finding showed the pattern of cholesterol changes seen in people with tendinopathy was similar to that which increases cardiovascular risk. This may seem to tell that what is bad for your heart is bad for your tendons. Researchers say that cholesterol deposits lead to inflammation of the tendon. In the long run, the structural changes will make the area vulnerable to injury and pain.


The relationship between high cholesterol and tendinopathy was seen in a recent study. A well-known comorbidity of obesity is high cholesterol, an established risk factor for coronary heart disease.

Cholesterol accumulates in the tendons, where it may be involved in structural disruption of the collagen matrix, similar to that seen in tendinopathy. This was seen in patients with familial hypercholesterolaemia, a genetic lipid metabolism disorder characterised by lifelong elevation of cholesterol.

The researchers believe that cholesterol deposits lead to inflammation of the tendons, which leads to structural changes that make the area at risk to pain and injury. In the studies, it was seen that people with unhealthy blood cholesterol levels were more likely in general to acquire tendon problems, and to have worse pain related to arm and shoulder musculoskeletal injuries. However, the findings can’t prove that high cholesterol causes tendon issues.

The relationship between tendinopathy and cholesterol could work vice versa. Tendon injury can also affect physical activity, and then affect cholesterol. This was noted by the authors in the British Journal of Sports Medicine.

Early detection of high cholesterol and management of cardiovascular disease risk can be beneficial for people with tendinopathy.


Because tendinopathy and cholesterol can work in reverse, physiotherapy helps in combating these two together by promoting exercises.

Physiotherapy has been commonly used for the treatment of tendinopathies. Stretching and strengthening programs are a common component of most therapy programs.

The intervention starts by initially addressing pain reduction, followed by a progressive resistance exercises to strengthen weak areas, power exercises to enhance the capacity in the stretch-shorten cycle, and finally functional return-to-sport training.

It is recommended to have proper load management to reduce symptoms. Although complete rest is important to avoid tendon loading, it will only reduce the load capacity of the tendon. Some useful ways to reduce load without resorting to complete rest include refraining from training with high-load drills, reducing training frequency, and reducing training time.

According to 2014 Journal of Physiotherapy, functional strengthening must address high-load tendon capacity as well as kinetic chain deficits and movement patterns. Once these patterns have improved, you can begin sports-specific training.

See a Perth physiotherapist if you need help with tendinopathy. Call us today at 9444 8729!