Lived Experiences of People With Lower Limb Tendinopathy-A Systematic Review With Qualitative Evidence Synthesis

Abstract

OBJECTIVE: To synthesize qualitative research exploring patient experiences of lower limb tendinopathies and identify themes to support patient-centered care. DESIGN: Systematic review with thematic synthesis. LITERATURE SEARCH: MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and SPORTDiscus were searched from inception to September 2024, using MeSH (Medical Subject Headings) terms and key words. Forward and backward citation tracking of included studies was performed in Web of Science. STUDY SELECTION CRITERIA: Peer-reviewed qualitative studies published at any date and using interviews or focus groups exploring perspectives on common lower limb tendinopathies (plantar heel pain, Achilles tendinopathy, tibialis posterior tendinopathy, patellar tendinopathy, gluteal tendinopathy, or proximal hamstring tendinopathy) were included. Participants of any age were eligible if diagnosed by a health care professional and symptomatic for at least 3 months. DATA SYNTHESIS: Thematic synthesis was conducted using an inductive approach. Two reviewers independently coded data. Descriptive themes were developed, refined through discussion, and structured into final analytical themes. RESULTS: Thirteen studies were included (n = 153; 84 females), with Achilles tendinopathy being the most common focus (n = 70; 7 studies). Ten themes were identified and organized hierarchically. These included psychosocial impacts; activity limitations; knowledge gaps regarding diagnoses, causes, and management; the importance of therapeutic alliance; and mixed treatment experiences. Six of 29 items in the Critical Appraisal Skills Programme Checklist for Qualitative Studies were unmet in over half of the studies. Confidence in findings ranged from low to moderate (GRADE-CERQual [Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative Research]). CONCLUSION: Lower limb tendinopathies impact patients beyond physical pain, affecting work, daily function, and sports and social participation. These challenges often lead to psychosocial consequences, including frustration, anxiety, and isolation. Strong therapeutic alliances can improve patient experiences and satisfaction with care. J Orthop Sports Phys Ther 2026;56(6):334-345. Epub 23 April 2026. doi:10.2519/jospt.2026.13666.