Tendinopathy (tendon injuries) can develop in any tendon of the body. You may have heard of tendinopathies being referred to as its aliases: tendonitis, tendinitis, tenosynovitis and tendinosis. In simple terms, they are all tendon injury pathologies so the medical community now refers to them as tendinopathies.
Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to occur suddenly, but usually, it is the result of repetitive tendon overloading. As mentioned earlier, health care professionals may use different terms to describe a tendon injury. You may hear:
The inability of your tendon to adapt to the load quickly enough causes the tendon to progress through four phases of tendon injury. While it is healthy for normal tissue adaptation during phase one, further progression can lead to tendon cell death and subsequent tendon rupture.
1. Reactive Tendinopathy
2. Tendon Dysrepair
3. Degenerative Tendinopathy
4. Tendon Tear or Rupture
It is very important to have your tendinopathy professionally assessed to identify it’s current injury phase. Identifying your tendinopathy phase is also vital to direct your most effective treatment since certain treatment modalities or exercises should only be applied or undertaken in specific tendon healing phases.
The evidence is growing that it is more than just the tendon and overload that causes tendinopathy. Diabetics, post-menopausal women and men with high central adiposity (body fat) seem to be predisposed to tendinopathies and will need to carefully watch their training loads.
To diagnose a tendon injury, your physiotherapist or doctor will ask questions about your past health, your symptoms and recent exercise regime. They'll undertake a thorough physical examination to confirm the diagnosis. They will then discuss your condition and devise an individualised treatment plan.
They may refer you for specific diagnostic tests, such as an ultrasound scan or MRI.
Tendinopathies can normally be quickly and effectively rehabilitated. However, there is a percentage of tendinopathies that can take months to treat effectively.
As mentioned earlier in this article, it is important to know what phase your tendinopathy currently is. Our physiotherapist can assist not only your diagnosis but also guide your treatment to fast-track your recovery.
Before you seek the advice of your physiotherapist or doctor, you can start treating an acute tendon injury at home. To achieve the best results, start these steps right away:
Rest the painful area, and avoid any activity that makes the pain worse.
Apply ice or cold packs for 20 minutes at a time, as often as 2 times an hour, for the first 72 hours. Keep using ice as long as it helps.
Do gentle range-of-motion exercises and stretching to prevent stiffness.
Every tendinopathy is different, so please be guided by your physiotherapist assessment. It may take weeks or months for some tendon injury to heal and safely cope with a return to sporting loads. Be patient, and stick with the treatment exercises and load doses prescribed by your physiotherapist. If you start using the injured tendon too soon, it can lead to more damage, and set you back weeks!
To minimise reinjuring your tendon, you may require some long-term changes to your exercise activities. These should be discussed with your physiotherapist. Some factors that could influence your tendinopathy risk include:
While most acute tendinopathies can resolve quickly, persisting tendon injuries may take many months to resolve. Long-term or repeat tendinopathies usually have multifactorial causes that will require a thorough assessment and individualised rehabilitation plan. Researchers have found that tendon injuries do respond differently to muscle injuries and can take months to solve or potentially render you vulnerable to tendon ruptures, which can require surgery.
For specific advice regarding your tendinopathy, please seek the advice of our trusted Physiotherapist with a special interest in tendinopathies.
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