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§ Fluoroquinolones display a high affinity for connective tissue,
particularly in cartilage and bone
§ Risk factors for fluoroquinolone-associated tendinopathy
include older than 60 yrs, concomitant corticosteroid therapy, renal dysfunction, and history of solid organ transplantation
Biddell et al. Pharmacotherapy 2016. § In an evaluation of more than 11 000 patients, rates of 2.4
incidences per 10 000 patient prescriptions for tendinitis and 1.2 per 10 000 for tendon rupture were cited.
Lewis and Cook, J Athl Train, 2014
Fluoroquinolone- related Tendinopathy Guidelines for Fluoroquinolone Use in Athletes
- 1. Avoid the use of fluoroquinolones unless no alternative is
available.
- 2. Oral or injectable corticosteroids should not be used
concomitantly with fluoroquinolones.
- 3. Athletes, coaches, and training staff should understand the
potential risk for developing this complication.
- 4. Close monitoring of the athlete should be undertaken for 1
month after fluoroquinolone use.
Glucocorticoid Steroids
§ Low-dose corticosteroids in isolation have been implicated in
Achilles tendon rupture
§ Khaliq and Zhanel reported that 21 of 40 patients (52.5%)
with fluoroquinolone-related tendon rupture had received systemic or inhaled corticosteroids. Patients prescribed both fluoroquinolones and corticosteroids had a 46-fold greater risk of Achilles tendon rupture than those taking neither medication.
Kinesiophobia
§ Described in 1990 by Kori et al. § Kinesiophobia is described as irrational, weakening and
devastating fear of movement and activity stemming from the belief of fragility and susceptibility to injury.
§ Symptoms occur when individual has to increase activity § Various defence mechanisms may appear, such as:
repression (removing from consciousness), negation (there is no need for movement), simulation and projection (sports fan behaviour) or, most frequently used, rationalisation (e.g. lacking time).
Knapik A, et al. J Hum Kinet. 2011.
