Tendinopathy

Ongoing Pain? Is it your tendon?

This is the first in a series of articles focusing on a very common problem across a broad range of the population.

You’ve had an annoying pain or discomfort for quite some time but can’t pin point when you first noticed it.  It’s now been weeks or months; and continues to niggle during certain activities, movements or positions. The pain is not always there, but it’s distinct in its location and enough to be a nuisance or worse.  Of late it’s starting to impact on things you enjoy doing or need to do, exercise, sitting, driving, sleeping!! 

Nothing seems to fix it and you’re getting impatient. You’ve rested, had it massaged; stretched; even used the spiky ball and foam roller to no avail.

 It could be the tendon…

 

What is Tendinopathy?

Tendinopathy is an injury to the tendon; the term encompasses all tendon pathologies you may have heard, including tendonitis, tendinitis, tendinosis and tenosynovitis.  A tendinopathy is mostly due to overuse of the tendon.  It is a disease of the lifespan, developing after years of repetitive actions and load placed upon it. 

Tendons connect muscle to bone and are responsible for storing and releasing energy.  If too much force is applied either suddenly or over time, they can break down or tear.  This article will highlight the signs and symptoms of tendinopathy and how we go about treating this pathology.

  

Signs it could be Tendinopathy

You therapist is the best person to determine if there is a tendinopathy pathology going on, but you may recognise a few of the symptoms and signs below.

  • Tendinopathy is not considered to be an inflammatory response.  Therefore, taking anti-inflammatory medication is unlikely to ease the discomfort. This may differ for acute presentations or those linked with bursitis involvement.

  • The pain can be linked to a change in intensity, duration or load of an activity. A runner presenting with Achilles tendinopathy may link the pain with an increase in kilometres run, or an increase in the intensity of training sessions.   Reducing the aggravating load (initially at least), is important in the recovery of a tendon.  For example: someone with a hamstring tendinopathy might be advised to sit as little as possible to avoid compression on the hamstring tendon.

  • Rest rarely helps.  As soon as you start your activity again, the pain will return.

    Passive treatments including massage, stretching (which is actually a no, no with tendon pathologies), NSAIDS, injections and shock wave therapy will rarely work independently of an exercise program.

  • The pain tends to be local. You can normally pinpoint where you are feeling the pain.

 

Treatment Options

Tendinopathies can take many months to rehabilitate back to optimal function.   The aim of rehab is to enable the tendon to cope with load again and get you back to doing what you need to do (walking, running, jumping, lifting, etc.).  Strengthening the ‘healthy’ part of the tendon and surrounding muscles is imperative in order to achieve this goal.  It is a slow process, and is not something that can be fixed after a few visits, it requires commitment of the program set for you.

 

Common Tendinopathies – each will be covered in future articles.

·      Gluteal

·      Patella

·      Rotator Cuff

·      Hamstring

·      Achilles

 

Myotherapy for Tendinopathy

At the Myotherapy and Movement Clinic we are trained in treating tendinopathy conditions.  Your treatment will be individualized and targeted. It will include a progressive loading program and other treatments that may help the individual get back to optimal health.