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  • Writer's pictureMark Austin

Tendinopathies: What You Need to Know

At physiobox, I see tendon injuries, known as tendinopathies, almost every day. Let's get into what tendinopathies are, and how we get things feeling better.


What are Tendinopathies?

A tendinopathy is a term used to describe a painful condition that affects a tendon. A tendon is a strong band of white tissue that connects your muscles to your bones. A tendinopathy is a common injury that can occur in any tendon of the body, but most commonly affects the shoulder, elbow, wrist, hip, knee, and ankle. This includes tennis and golfer’s elbow, most rotator cuff injuries, and more. Tendinitis and tendinosis are both forms of tendinopathies.


Causes

A tendinopathy can be caused by a variety of factors, including:

· Overuse: Repeated use of a tendon can cause it to break down over time and become painful.

· Aging: As we age, our tendons become less flexible and more prone to injury.

· Poor biomechanics: Abnormal or poor movement patterns can put increased stress on tendons.

· Trauma: A sudden injury or accident can cause a tendon to tear or rupture.


Symptoms

A tendinopathy typically presents with the following symptoms:

· Pain: The most common symptom is pain at the site of the affected tendon.

· Swelling: The affected area may be swollen and tender to the touch, especially if the injury was traumatic in nature

· Stiffness: You may experience stiffness or limited range of motion in the affected joint.

· Weakness: You may notice a decrease in strength or power of the affected limb.

Diagnosis

A tendinopathy can often be diagnosed through a physical examination by a healthcare professional, such as a physiotherapist or a doctor. In some cases, imaging tests such as X-rays or an MRI may be required to confirm the diagnosis.


Treatment


Most tendinopathies get better with conservative management and time. With physiotherapy, many patients are back to normal in 6-12 weeks, while more complex cases can take 6 months to over a year to fully recover. The treatment of tendinopathy typically involves a combination of the following: Graduated Loading: Graduated loading is a treatment approach where the affected tendon is gradually exposed to increasing loads in a controlled manner. This helps the tendon to adapt and become stronger without causing further damage or pain. A physiotherapist can develop a customized exercise program that gradually increases the load on the affected tendon over time.

Mechanical Optimization and Movement Re-Education: If your physiotherapist determines that poor mechanics are contributing to excess stress on your tendons, you may be provided with exercises to maximize the strength and mobility of the surrounding joints and musculature.

Activity Management: Managing your activities without fear is a very important part of treating tendinopathy. This may involve modifying or avoiding certain activities that aggravate your symptoms. We will work with you to identify activities that may be contributing to your symptoms and help you modify them to reduce pain and promote healing. It is important to distinguish between pain which is a normal part of the healing process and pain which indicates further damage is occurring. It is important to challenge symptoms rather than avoid uncomfortable or painful activities altogether, providing the increase in discomfort is mild and settles shortly after finishing said activity.


Modalities: Modalities such as massage, acupuncture, and dry needling be helpful in reducing pain and promoting healing in tendinopathy. However, it is important to note that these modalities should be used in conjunction with exercise and activity management, rather than as standalone treatments. We will work together to help determine which modalities may be appropriate for you and your specific condition and develop a treatment plan that includes both exercise and modalities. Lifestyle Management: This part is important and often overlooked. Lifestyle factors such as stress, nutrition, sleep, and smoking can also affect tendinopathy. High levels of stress can contribute to muscle tension as well as slow down tissue recovery. Adequate nutrition and hydration are important for tissue repair, and maintaining a consistent sleep schedule and avoiding smoking can also promote healing and reduce your risk of complications or a slow recovery. We will take time to consider each of these factors in your recovery. Looking to start feeling better? Book in here for physiotherapy here in Calgary, Alberta.

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