Cholesterol: What’s Bad For Your Heart Is Bad For Your Tendons

Jamie Gaida, PhD Assistant Professor Discipline of Physiotherapy University of Canberra

Dr. Jamie Gaida Interview with:
Jamie Gaida, PhD
Assistant Professor
Discipline of Physiotherapy
University of Canberra

Medical Research: What is the background for this study? What are the main findings?

Dr. Gaida: Cholesterol is essential for life but having too much circulating in your blood increases cardiovascular disease risk. A growing collection of evidence indicates that metabolic health (i.e. cholesterol and diabetes) is linked to musculoskeletal injuries.

Tendons connect muscle to bone, and tendinopathy is condition where a person feels pain when using their tendons. People with Achilles tendinopathy experience pain when walking or when running, which limits their ability to be physically active. Tendinopathy also affects other tendons throughout the body, such as the rotator cuff tendons of the shoulder.

This research identified all published research on the link between cholesterol levels and tendinopathy. We used a statistical technique called meta-analysis to combine these studies, which showed that cholesterol levels are linked to tendinopathy. However, the most interesting finding was that the pattern of cholesterol changes seen with tendinopathy matched the pattern of cholesterol changes that increase cardiovascular disease risk. It seems that what is bad for you heart is bad for your tendons.

Medical Research: What should clinicians and patients take away from your report?

Dr. Gaida: People with high cholesterol levels appear to be at increased risk of developing tendon pain. High cholesterol might compromise tendon structure making it vulnerable to injury at lower levels of loading. People who increase their physical activity after finding out they have high cholesterol should do so gradually so that their tendons have time to adapt. Development of tendon pain could also be an early marker for high cholesterol, allowing for the early detection of possible cardiovascular disease.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Gaida: Musculoskeletal diseases place an enormous burden on individuals, hospital systems, and the workforce (through reduced productivity and sick leave). We need to recognise the role that metabolic factors play in musculoskeletal conditions and not just think of them as an overload issue. We need research funding agencies to recognise the impact these injuries will have on national health budgets as our population continues to age and obesity rates rise. This will prompt funding for large prospective studies to determine whether treating metabolic factors can speed recovery or prevent the injury in the first place.


Is higher serum cholesterol associated with altered tendon structure or tendon pain? A systematic review, British Journal of Sports Medicine

DOI: 10.1136/bjsports-2015-095100

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Jamie Gaida, PhD (2015). Cholesterol: What’s Bad For Your Heart Is Bad For Your Tendons 

Last Updated on October 17, 2015 by Marie Benz MD FAAD