The influence of ageing and exercise on tendon growth and degeneration–hypotheses for the initiation and prevention of strain-induced tendinopathies.
Abstract: Strain-induced tendinopathy is a common injury in both human and equine athletes, with increasing incidence associated with greater involvement in sport and an increasingly aged population. This paper reviews our studies on the abundant non-collagenous protein, cartilage oligomeric matrix protein (COMP), in equine tendons. Its variation between tendon type and site, age and exercise has provided an insight into how age and exercise influence tendon growth and maturation. Tendons can be broadly divided into two types, reflecting their different matrix composition and function: the energy-storing tendons used for weight-bearing and locomotion, which suffer a high incidence of strain-induced tendinopathy, and positional tendons involved in limb placement or manipulative skills. It would appear that while energy-storing tendon can respond to the mechanical forces applied to it during growth, there is no evidence that it can do so after skeletal maturity. Instead, cumulative fatigue damage causes degeneration at the molecular level, potentially weakening it and increasing the risk of clinical injury. Appropriate exercise regimes early in life may help to improve the quality of growing tendon, thereby reducing the incidence of injury during ageing or subsequent athletic career.
Publication Date: 2002-12-18 PubMed ID: 12485691DOI: 10.1016/s1095-6433(02)00148-4Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
- Review
Summary
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This research article investigates how aging and exercise affects the growth and decay of tendons, especially in terms of tendinopathy, a common injury found in athletes. It particularly discusses the role of a protein called cartilage oligomeric matrix protein (COMP) in equine tendons to provide insights on the influence of age and exercise on tendon health.
Research Objectives and Methodology
- The primary goal of this study is to understand the influence of age and exercise on tendon growth and maturation. It aims to identify mechanisms that may lead to strain-induced tendinopathy and how it may be prevented. The article focuses on both human and equine athletes, as both groups exhibit a high incidence of tendinopathy.
- The researchers used the model of equine tendons to study the role and variation of the non-collagenous protein, cartilage oligomeric matrix protein (COMP). They focused on changes according to tendon type, age, and levels of exercise.
Main Findings and Insights
- Tendons can be divided into two categories based on matrix composition and function: energy-storing tendons, used for weight-bearing and locomotion, which often undergo strain-induced tendinopathy, and positional tendons, involved in limb placement or manipulative skills.
- The study suggests that energy-storing tendons can respond to mechanical forces during the growth phase, but evidence shows they cannot do so after skeletal maturity. Instead, accumulated fatigue damage leads to molecular-level degeneration, potentially weakening the tendon and increasing the risk of injury.
- The role and the presence of the COMP protein vary with tendon type, age, and level of exercise. This provides insights into the underlying biological processes that influence tendon growth and maturation.
Conclusions and Implications
- The research suggests that appropriate exercise routines early in life can enhance the quality of growing tendons, thus reducing the likelihood of injury as one ages or during an athletic career. The prevention of strain-induced tendinopathy is more effective during the growth phase rather than after skeletal maturity.
- The findings from the study bear relevance for both human and equine athletes, opening up avenues for developing therapeutic applications targeted towards tendon health, and offering strategies for injury prevention in both groups.
Cite This Article
APA
Smith RK, Birch HL, Goodman S, Heinegård D, Goodship AE.
(2002).
The influence of ageing and exercise on tendon growth and degeneration–hypotheses for the initiation and prevention of strain-induced tendinopathies.
Comp Biochem Physiol A Mol Integr Physiol, 133(4), 1039-1050.
https://doi.org/10.1016/s1095-6433(02)00148-4 Publication
Researcher Affiliations
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts. AL9 7TA, UK. rksmith@rvc.ac.uk
MeSH Terms
- Aging / physiology
- Animals
- Cartilage Oligomeric Matrix Protein
- Exercise / physiology
- Extracellular Matrix Proteins / metabolism
- Glycoproteins / metabolism
- Horses
- Humans
- Matrilin Proteins
- Tendon Injuries / physiopathology
- Tendon Injuries / prevention & control
- Tendons / growth & development
- Tendons / metabolism
- Tendons / pathology
Citations
This article has been cited 51 times.- Waugh CM, Mousavizadeh R, Lee J, Screen HRC, Scott A. Mild hypercholesterolemia impacts achilles sub-tendon mechanical properties in young rats. BMC Musculoskelet Disord 2023 Apr 12;24(1):282.
- Ribbans WJ, September AV, Collins M. Tendon and Ligament Genetics: How Do They Contribute to Disease and Injury? A Narrative Review. Life (Basel) 2022 Apr 29;12(5).
- Jiang H, Lin X, Liang W, Li Y, Yu X. Friedelin Alleviates the Pathogenesis of Collagenase-Induced Tendinopathy in Mice by Promoting the Selective Autophagic Degradation of p65. Nutrients 2022 Apr 18;14(8).
- Crawford KL, Finnane A, Greer RM, Barnes TS, Phillips CJC, Woldeyohannes SM, Bishop EL, Perkins NR, Ahern BJ. Survival Analysis of Training Methodologies and Other Risk Factors for Musculoskeletal Injury in 2-Year-Old Thoroughbred Racehorses in Queensland, Australia. Front Vet Sci 2021;8:698298.
- Wagner FC, Reese S, Gerlach K, Böttcher P, Mülling CKW. Cyclic tensile tests of Shetland pony superficial digital flexor tendons (SDFTs) with an optimized cryo-clamp combined with biplanar high-speed fluoroscopy. BMC Vet Res 2021 Jun 25;17(1):223.
- Wagner FC, Gerlach K, Geiger SM, Gittel C, Böttcher P, Mülling CKW. Biplanar High-Speed Fluoroscopy of Pony Superficial Digital Flexor Tendon (SDFT)-An In Vivo Pilot Study. Vet Sci 2021 May 27;8(6).
- Pownder SL, Hayashi K, Lin BQ, Meyers KN, Caserto BG, Breighner RE, Potter HG, Koff MF. Differences in the magnetic resonance imaging parameter T2* may be identified during the course of canine patellar tendon healing: a pilot study. Quant Imaging Med Surg 2021 Apr;11(4):1234-1246.
- Crawford KL, Finnane A, Greer RM, Phillips CJC, Bishop EL, Woldeyohannes SM, Perkins NR, Ahern BJ. A Prospective Study of Training Methods for Two-Year-Old Thoroughbred Racehorses in Queensland, Australia, and Analysis of the Differences in Training Methods between Trainers of Varying Stable Sizes. Animals (Basel) 2021 Mar 25;11(4).
- Crawford KL, Finnane A, Greer RM, Phillips CJC, Woldeyohannes SM, Perkins NR, Ahern BJ. Appraising the Welfare of Thoroughbred Racehorses in Training in Queensland, Australia: The Incidence, Risk Factors and Outcomes for Horses after Retirement from Racing. Animals (Basel) 2021 Jan 11;11(1).
- Gittings D, Riggin C, Boorman-Padgett J, Weiss S, Fryhofer G, Farber D, Steinberg D, Soslowsky LJ. Chronic Nicotine Exposure Alters Uninjured Tendon Vascularity and Viscoelasticity. Foot Ankle Orthop 2019 Apr;4(2).
- Yan Z, Yin H, Brochhausen C, Pfeifer CG, Alt V, Docheva D. Aged Tendon Stem/Progenitor Cells Are Less Competent to Form 3D Tendon Organoids Due to Cell Autonomous and Matrix Production Deficits. Front Bioeng Biotechnol 2020;8:406.
- Smith R, Önnerfjord P, Holmgren K, di Grado S, Dudhia J. Development of a Cartilage Oligomeric Matrix Protein Neo-Epitope Assay for the Detection of Intra-Thecal Tendon Disease. Int J Mol Sci 2020 Mar 20;21(6).
- Durgam SS, Altmann NN, Coughlin HE, Rollins A, Hostnik LD. Insulin Enhances the In Vitro Osteogenic Capacity of Flexor Tendon-Derived Progenitor Cells. Stem Cells Int 2019;2019:1602751.
- Ribitsch I, Gueltekin S, Keith MF, Minichmair K, Peham C, Jenner F, Egerbacher M. Age-related changes of tendon fibril micro-morphology and gene expression. J Anat 2020 Apr;236(4):688-700.
- Eriksen CS, Svensson RB, Gylling AT, Couppé C, Magnusson SP, Kjaer M. Load magnitude affects patellar tendon mechanical properties but not collagen or collagen cross-linking after long-term strength training in older adults. BMC Geriatr 2019 Jan 31;19(1):30.
- Guzzoni V, Selistre-de-Araújo HS, Marqueti RC. Tendon Remodeling in Response to Resistance Training, Anabolic Androgenic Steroids and Aging. Cells 2018 Dec 7;7(12).
- Magnusson SP, Kjaer M. The impact of loading, unloading, ageing and injury on the human tendon. J Physiol 2019 Mar;597(5):1283-1298.
- Turlo AJ, Ashraf Kharaz Y, Clegg PD, Anderson J, Peffers MJ. Donor age affects proteome composition of tenocyte-derived engineered tendon. BMC Biotechnol 2018 Jan 16;18(1):2.
- Wu F, Nerlich M, Docheva D. Tendon injuries: Basic science and new repair proposals. EFORT Open Rev 2017 Jul;2(7):332-342.
- Pardes AM, Beach ZM, Raja H, Rodriguez AB, Freedman BR, Soslowsky LJ. Aging leads to inferior Achilles tendon mechanics and altered ankle function in rodents. J Biomech 2017 Jul 26;60:30-38.
- Molyneux P, Carroll M, Stewart S, Brenton-Rule A, Rome K. Ultrasound characteristics of the mid-portion of the Achilles tendon in runners: a systematic review protocol. Syst Rev 2017 May 30;6(1):108.
- Lee AH, Szczesny SE, Santare MH, Elliott DM. Investigating mechanisms of tendon damage by measuring multi-scale recovery following tensile loading. Acta Biomater 2017 Jul 15;57:363-372.
- Zhang X, Lin YC, Rui YF, Xu HL, Chen H, Wang C, Teng GJ. Therapeutic Roles of Tendon Stem/Progenitor Cells in Tendinopathy. Stem Cells Int 2016;2016:4076578.
- Gilbert SJ, Meakin LB, Bonnet CS, Nowell MA, Ladiges WC, Morton J, Duance VC, Mason DJ. Deletion of P58(IPK), the Cellular Inhibitor of the Protein Kinases PKR and PERK, Causes Bone Changes and Joint Degeneration in Mice. Front Endocrinol (Lausanne) 2014;5:174.
- Shepherd JH, Riley GP, Screen HR. Early stage fatigue damage occurs in bovine tendon fascicles in the absence of changes in mechanics at either the gross or micro-structural level. J Mech Behav Biomed Mater 2014 Oct;38:163-72.
- Dakin SG, Smith RK, Heinegård D, Önnerfjord P, Khabut A, Dudhia J. Proteomic analysis of tendon extracellular matrix reveals disease stage-specific fragmentation and differential cleavage of COMP (cartilage oligomeric matrix protein). J Biol Chem 2014 Feb 21;289(8):4919-27.
- Rich T, Henderson LB, Becker DL, Cornell H, Patterson-Kane JC. Indicators of replicative damage in equine tendon fibroblast monolayers. BMC Vet Res 2013 Sep 11;9:180.
- Kohler J, Popov C, Klotz B, Alberton P, Prall WC, Haasters F, Müller-Deubert S, Ebert R, Klein-Hitpass L, Jakob F, Schieker M, Docheva D. Uncovering the cellular and molecular changes in tendon stem/progenitor cells attributed to tendon aging and degeneration. Aging Cell 2013 Dec;12(6):988-99.
- Sereysky JB, Flatow EL, Andarawis-Puri N. Musculoskeletal regeneration and its implications for the treatment of tendinopathy. Int J Exp Pathol 2013 Aug;94(4):293-303.
- Muttini A, Salini V, Valbonetti L, Abate M. Stem cell therapy of tendinopathies: suggestions from veterinary medicine. Muscles Ligaments Tendons J 2012 Jul;2(3):187-92.
- Thorpe CT, Birch HL, Clegg PD, Screen HR. The role of the non-collagenous matrix in tendon function. Int J Exp Pathol 2013 Aug;94(4):248-59.
- Södersten F, Hultenby K, Heinegård D, Johnston C, Ekman S. Immunolocalization of collagens (I and III) and cartilage oligomeric matrix protein in the normal and injured equine superficial digital flexor tendon. Connect Tissue Res 2013;54(1):62-9.
- Killian ML, Cavinatto L, Galatz LM, Thomopoulos S. The role of mechanobiology in tendon healing. J Shoulder Elbow Surg 2012 Feb;21(2):228-37.
- Farris DJ, Trewartha G, McGuigan MP. The effects of a 30-min run on the mechanics of the human Achilles tendon. Eur J Appl Physiol 2012 Feb;112(2):653-60.
- van Sterkenburg MN, Kerkhoffs GM, van Dijk CN. Good outcome after stripping the plantaris tendon in patients with chronic mid-portion Achilles tendinopathy. Knee Surg Sports Traumatol Arthrosc 2011 Aug;19(8):1362-6.
- Murray SJ, Santangelo KS, Bertone AL. Evaluation of early cellular influences of bone morphogenetic proteins 12 and 2 on equine superficial digital flexor tenocytes and bone marrow-derived mesenchymal stem cells in vitro. Am J Vet Res 2010 Jan;71(1):103-14.
- Longo UG, Fazio V, Poeta ML, Rabitti C, Franceschi F, Maffulli N, Denaro V. Bilateral consecutive rupture of the quadriceps tendon in a man with BstUI polymorphism of the COL5A1 gene. Knee Surg Sports Traumatol Arthrosc 2010 Apr;18(4):514-8.
- Ensey JS, Hollander MS, Wu JZ, Kashon ML, Baker BB, Cutlip RG. Response of tibialis anterior tendon to a chronic exposure of stretch-shortening cycles: age effects. Biomed Eng Online 2009 Jun 29;8:12.
- Kilts T, Ameye L, Syed-Picard F, Ono M, Berendsen AD, Oldberg A, Heegaard AM, Bi Y, Young MF. Potential roles for the small leucine-rich proteoglycans biglycan and fibromodulin in ectopic ossification of tendon induced by exercise and in modulating rotarod performance. Scand J Med Sci Sports 2009 Aug;19(4):536-46.
- Kim HJ, Lee YH, Kim CK. Changes in serum cartilage oligomeric matrix protein (COMP), plasma CPK and plasma hs-CRP in relation to running distance in a marathon (42.195 km) and an ultra-marathon (200 km) race. Eur J Appl Physiol 2009 Mar;105(5):765-70.
- Bui KL, Ilaslan H, Recht M, Sundaram M. Iliopsoas injury: an MRI study of patterns and prevalence correlated with clinical findings. Skeletal Radiol 2008 Mar;37(3):245-9.
- Stanley RL, Fleck RA, Becker DL, Goodship AE, Ralphs JR, Patterson-Kane JC. Gap junction protein expression and cellularity: comparison of immature and adult equine digital tendons. J Anat 2007 Sep;211(3):325-34.
- Smith RK, Webbon PM. Harnessing the stem cell for the treatment of tendon injuries: heralding a new dawn?. Br J Sports Med 2005 Sep;39(9):582-4.
- Valencia M, Monroy J, Garland T Jr, Horner AM. Early-life exercise effects on Achilles tendon in mice selectively bred for high voluntary wheel-running behavior. Physiol Rep 2025 Aug;13(16):e70515.
- Scharf A, Acutt E, Bills K, Werpy N. Magnetic resonance imaging for diagnosing and managing deep digital flexor tendinopathy in equine athletes: Insights, advances and future directions. Equine Vet J 2025 Sep;57(5):1183-1203.
- Hefferan SA, Blaker CL, Ashton DM, Little CB, Clarke EC. Structural Variations of Tendons: A Systematic Search and Narrative Review of Histological Differences Between Tendons, Tendon Regions, Sex, and Age. J Orthop Res 2025 May;43(5):994-1011.
- Li S, Liu J, Wang Y, Zhu C, Tang Y, Gu M. Clinical evaluation of the efficacy of focused extracorporeal shock-wave therapy in patients with cervical spondylosis: A randomized control trial. Medicine (Baltimore) 2024 Nov 15;103(46):e40573.
- Hanousek K, Fiske-Jackson A, O'Leary L, Smith RKW. Injury to the palmar supporting structures of the fetlock alters limb stiffness and fetlock angle. Equine Vet J 2025 May;57(3):636-644.
- Heidari N, Faragher RGA, Pattison G, Dudhia J, Smith RKW. A SIRT1-independent mechanism mediates protection against steroid-induced senescence by resveralogues in equine tenocytes. PLoS One 2024;19(8):e0309301.
- Huff RD, Houghton F, Earl CC, Ghajar-Rahimi E, Dogra I, Yu D, Harris-Adamson C, Goergen CJ, O'Connell GD. Deep learning enables accurate soft tissue tendon deformation estimation in vivo via ultrasound imaging. Sci Rep 2024 Aug 8;14(1):18401.
- Lin TY, Chen JT, Chen YY, Chen TW, Lee CL, Chen CH, Huang MH. The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification. Kaohsiung J Med Sci 2015 Jul;31(7):337-43.
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