Do GLP-1 Drugs Like Ozempic and Wegovy Increase Tendon Rupture Risk?
- Joshua Silva, MD
- 3 days ago
- 4 min read
Medically authored by Joshua Silva, MD | Evidence-Based Weight Loss at Potere Health MD
What the 2026 Study Found
Early research presented at the 2026 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting found that patients with obesity taking GLP-1 medications such as semaglutide (Ozempic®, Wegovy®) may have a higher relative risk of certain tendon ruptures. However, the absolute risk increase appears small, and
most patients taking GLP-1 medications do not experience tendon injury.¹,²
Quick Facts: GLP-1 Drugs and Tendon Rupture Risk
Over five years, researchers observed slightly higher rates of several tendon injuries among GLP-1 users compared with non-users.
Tendon Injury | GLP-1 Users | Non-Users | Absolute Increase |
Rotator cuff rupture | 2.4% | 1.5% | +0.9% |
Achilles tendon rupture | 0.3% | 0.2% | +0.1% |
Pectoralis major rupture | 0.8% | 0.5% | +0.3% |
These results correspond to relative risk increases of roughly 46%–55%, depending on the tendon studied.²
Even with these increases, the vast majority of patients did not experience a tendon rupture.
What Did the 2026 GLP-1 Tendon Study Find?
Researchers led by Jad Lawand, MD, at the University of Texas Medical Branch analyzed health-record data comparing patients with obesity taking GLP-1 receptor agonists with matched patients not taking these medications.²
The study identified increased relative risk of three major tendon injuries:
Rotator cuff rupture (shoulder)
Achilles tendon rupture (heel)
Pectoralis major rupture (chest)
Hazard ratios reported in the analysis were approximately:
1.55 — Rotator cuff rupture
1.49 — Achilles tendon rupture
1.46 — Pectoralis major rupture²
Because the research was based on retrospective health-record data, the findings demonstrate a statistical association rather than proof that GLP-1 medications directly cause tendon injury.¹,²
How Big Is the Risk? (Numbers Patients Can Understand)
Relative risk increases can sound alarming. Looking at absolute risk provides better context.
Over five years, the differences reported in the study translate approximately to:
9 additional rotator cuff ruptures per 1,000 patients
3 additional pectoralis major ruptures per 1,000 patients
1 additional Achilles rupture per 1,000 patients
Even with these increases, more than 97% of patients taking GLP-1 medications did not experience a tendon rupture during the study period.
Why Might GLP-1 Medications Affect Tendons?
The study did not identify a confirmed biological mechanism, but experts have proposed several possible explanations.
1. Rapid increases in physical activity
As patients lose weight, they often become more active. Sudden increases in exercise—especially running, tennis, or pickleball—may place new stress on tendons that have not yet adapted.
2. Changes in collagen signaling
Researchers are exploring whether GLP-1 receptors in connective tissue could influence collagen remodeling and tendon repair.
3. Nutritional or metabolic changes
Significant weight loss can alter bone metabolism, nutrient levels, and endocrine signaling, which could indirectly influence tendon health.³
Further research will be needed to clarify these mechanisms.
Should You Stop Taking Ozempic or Wegovy Because of Tendon Risk?
No. Current evidence does not support stopping GLP-1 medications because of this preliminary research.
GLP-1 receptor agonists have demonstrated major health benefits in large clinical trials, including:
Significant weight loss
Improved blood sugar control
Reduced cardiovascular risk
For most patients, the metabolic and cardiovascular benefits of treatment far outweigh the potential risk of tendon injury.¹,³
How to Reduce Tendon Injury Risk While on GLP-1 Therapy
Patients using GLP-1 medications can reduce injury risk with simple precautions.
Practical tips:
Increase exercise gradually
Avoid sudden spikes in high-impact activities
Warm up before workouts
Strengthen supporting muscles
Seek medical care for sudden tendon pain, especially in the Achilles tendon or shoulder
Gradual training progression allows tendons to adapt safely during weight loss.
Key Takeaways: GLP-1 Drugs and Tendon Rupture
A 2026 conference study found higher relative risk of certain tendon ruptures among GLP-1 users.
The absolute risk increase appears small.
Most patients taking GLP-1 medications do not experience tendon injury.
Gradual increases in physical activity may reduce injury risk.
For most patients, the benefits of GLP-1 therapy likely outweigh this potential risk.
Disclaimer
This article is for educational purposes only and is not a substitute for medical advice.
About the Author
Dr. Joshua Silva, MD, is a licensed physician and Medical Director of Potere Health MD. He earned his medical degree from the University of Hawaiʻi John A. Burns School of Medicine and completed residency training in Occupational and Environmental Medicine at the University of Utah, where he also earned a master’s degree in Occupational Health. He later completed a Master of Business Administration with an emphasis in health care administration at Ohio University.
Dr. Silva specializes in evidence-based weight management, including GLP-1 and GIP therapies such as semaglutide and tirzepatide. He closely monitors emerging research on medication safety including potential musculoskeletal risks like tendon injury. He provides in-person and virtual care for patients in Salt Lake City, St. George, and Cedar City, Utah.
Sources:
Lawand J, et al. GLP-1 receptor agonist use and musculoskeletal outcomes in patients with obesity. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 2026.
Hensel J. Tendon rupture risk linked to GLP-1 use in obese patients. Medscape. March 12, 2026. Accessed March 13, 2026. https://www.medscape.com/viewarticle/tendon-rupture-risk-linked-glp-1-use-obese-patients-2026a10006z8
Cunningham P. Weight-loss drugs tied to bone and tendon injury risks in early research. The Washington Post. March 8, 2026. Accessed March 13, 2026.
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