Some people living with transthyretin amyloid cardiomyopathy (ATTR-CM) experience musculoskeletal issues that may point to the condition years before diagnosis.

In fact, your doctor may learn about tendon ruptures or other musculoskeletal problems, such as a biceps tendon rupture, rotator cuff injury, or lumbar spinal stenosis (narrowing around the nerves in the lower back), before you’ve had any heart symptoms at all.

“A sharp cardiologist caught my heart issue pretty early with a 3D echocardiogram. I had bilateral carpal tunnel three years before and a torn bicep tendon 10 years before, but who knew?” one MyAmyloidosisTeam member said.

🗳️ Did you experience a tendon rupture before your transthyretin amyloid cardiomyopathy (ATTR-CM) diagnosis?

Yes, I experienced one before my ATTR-CM diagnosis.

I experienced one only after my ATTR-CM diagnosis.

I haven’t experienced a tendon rupture.

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Keep reading to learn how transthyretin amyloid deposits may weaken tendons and affect other soft tissues before ATTR-CM is diagnosed. You’ll also learn why bringing musculoskeletal issues to your doctor’s attention may help them diagnose ATTR-CM earlier so you can start treatment sooner.

ATTR-CM and Tendon Damage: What’s the Link?

In people with transthyretin amyloidosis (ATTR amyloidosis), the transthyretin protein changes shape and forms amyloid deposits. When these deposits build up in the heart, the condition is called transthyretin amyloid cardiomyopathy. The deposits can stiffen the heart walls, making it harder for the heart to pump blood through the body.

“A sharp cardiologist caught my heart issue pretty early. I had a torn bicep tendon 10 years before, but who knew?”

— A MyAmyloidosisTeam member

Amyloid deposits can also build up in other parts of the body, including tendons, ligaments, and other tissues in the musculoskeletal system. The musculoskeletal system includes muscles, bones, joints, and tendons.

How Does ATTR-CM Damage Tendons?

Researchers believe ATTR amyloidosis damages the musculoskeletal system due to amyloid deposits building up in connective tissue. Amyloid deposits have even been found in bones.

Studies have shown that surgeons performing orthopedic surgery sometimes find amyloid deposits in musculoskeletal tissue long before an ATTR-CM diagnosis is made. These deposits may contribute to tendon or ligament problems in areas such as:

• The rotator cuff injuries
• The forearm
• The lower spine
• The biceps
• The Achilles tendon (located at the back of the heel)

Most tendon ruptures are unrelated to ATTR-CM. Most are caused by a traumatic injury, such as a sudden impact that stresses your body. Still, amyloidosis may be one factor that contributes to tendon weakness in some people.

“Does anyone have muscle or tendon tears known to be from the amyloid?” one MyAmyloidosisTeam member asked.

Another replied, “I have a tendon problem, but whether the amyloidosis is responsible or not is anyone’s guess.”

Tendon Rupture Symptoms

A tendon injury may cause sudden pain and may be accompanied by a popping or snapping noise. Some people also notice:

• Bruising
• Swelling
• Difficulty moving the affected body part

“My tendons are ripping,” one MyAmyloidosisTeam member said. “I feel like I’m walking on rocks. Pain is horrible.”

“I was diagnosed with ATTR-CM in 2025. About two years ago, I had carpal tunnel surgery and also a ruptured bicep tendon.”

— A MyAmyloidosisTeam member

If your healthcare provider suspects a ruptured tendon, they’ll perform an exam and ask about your symptoms. They may also perform imaging tests, such as an X-ray or MRI.

How Are Tendon Ruptures Treated?

Once your doctor diagnoses a ruptured tendon, they’ll create a treatment plan. This may include nonsurgical strategies or surgery in some cases.

Treatment options include:

• Rest, ice, compression, and elevation (RICE) to help limit pain and swelling soon after an injury
• A brace, splint, cast, or walking boot to protect the tendon and limit movement while it heals
• Physical therapy to gradually restore movement, strength, and function
• Pain-relieving or anti-inflammatory medication, when appropriate, to ease discomfort and swelling
• Tendon rupture repair surgery to reconnect the torn tendon and restore function when the injury is severe or unlikely to heal well without surgery

The best treatment option for you will depend on which tendon is injured, your activity level, overall health, whether the tear is partial or complete, and other factors.

How Soon Before Heart Symptoms Do Tendon Problems Start?

Tendon problems can happen long before people with ATTR-CM have heart symptoms. Some studies say that musculoskeletal issues can occur five to 15 years before an ATTR-CM diagnosis is made.

“I was diagnosed with ATTR-CM in 2025,” one MyAmyloidosisTeam member said. “About two years ago, I had carpal tunnel surgery and also a ruptured bicep tendon.”

Another member said, “I had progressive issues back 20 years, including trigger fingers, tendon ruptures, and shortness of breath.”

Some researchers believe that screening for amyloid deposits during common orthopedic surgeries could help providers detect ATTR-CM sooner. Some health experts believe tendon ruptures or carpal tunnel syndrome may be signs that doctors should check for ATTR-CM.

For instance, they could look for certain biomarkers in a person’s lab work, or they may screen for other risk factors.

If your care team finds amyloid deposits during tendon repair, or if you have heart symptoms too, your orthopedist can refer you to a cardiologist. They can perform testing to evaluate whether you may have ATTR-CM.

Contact Your Care Team

Because ATTR-CM is serious and may be life-threatening, it’s important to detect this condition as soon as possible. If you notice any new or changing symptoms anywhere in your body, talk to a healthcare professional.

This is especially true if you have a tendon rupture along with other possible ATTR-CM symptoms, such as:

• Shortness of breath
• Chest pressure
• Heart palpitations
• Ankle, leg, or abdomen swelling
• Dizziness
• Numbness, weakness, or pain
• Easy bruising

Detecting ATTR-CM early allows you to treat it sooner, which may help prevent complications and improve your outlook. Treatments aim to stop or slow down the buildup of amyloid deposits to stave off disease progression.

Your doctor may also recommend additional treatments to help you manage symptoms such as nerve pain or to control complications like heart failure.

In addition, it’s important to treat any musculoskeletal issues quickly, before they snowball into something bigger.

One MyAmyloidosisTeam member said they wished they’d addressed a tendon rupture when it occurred: “I had a tendon rupture when I was 65. I’m now 81, and it was never repaired. I cannot lift at arm’s length or much above my head.”

Reach out to your care team right away if you suspect you’ve experienced a tendon rupture or if you have any other potential ATTR-CM symptoms.

Join the Conversation

On MyAmyloidosisTeam, people share their experiences with amyloidosis, get advice, and find support from others who understand.

Have you had a tendon rupture while living with ATTR-CM? Let others know in the comments below.