Tendinopathies

A tendinopathy is essentially a disorder of the tendons. A commonly used term is tendonitis/tendinosis but I’m going to save you the anatomy and physiology lecture and show you what you need to know.

 

What you feel

  • You can pin point the exact location of the pain at the tendon either by pointing to it or by pinching the area.
  • It doesn’t refer. It will be sore in the exact area you feel it and only there.
  • It will be sore during rest and ease off when you are moving (warming up).
  • It will hurt to sit on hard surfaces (proximal hamstring tendinopathy) or lay on your side (glute medius tendinopathy).
  • You will most likely have morning stiffness or pain 24 hours after the activity.
  • It will hurt to do explosive movements (jumping, running, hopping etc).
  • It will be a sharp pain.
  • There will be pain while stretching or compressing the tendon against the bone.
  • There will have been a sudden increase in activity (boot camps).
  • You may have a history of insulin resistance diabetes.
  • Men who are more at risk have central adiposity (fat).
  • Women who are more at risk will be post menopausal.

 

What you need to know

  • Once a tendon always a tendon: meaning the tendon will stay the same structurally whether or not there is pain.
  • Isometric contractions, where you are contracting the muscle without moving the limbs, will decrease the pain more effectively than Panadol will as well as strengthen the tendon.
  • Tendons hate being compressed against bone. If you’re unsure of compression, it’s similar to stretch.
  • Massage doesn’t Well what’s the point of me then? We treat the limitations that may be caused by or are causing the tendinopathy.
  • Movement is the best medicine.
  • Avoid surgery and cortisone! Surgery doesn’t help and cortisone makes it worse.
  • It will get better. Patience is key, as tendons hate change, so progressions with exercise may be slow.
  • Scans are inconclusive. An ultrasound will tell me there are signs of tendinitis in an otherwise perfectly healthy supraspinatus (one of the rotator cuff muscles).
  • The time it takes to heal a tendon is dependant on each individual. Muscle and bone both take up to 12 weeks to recover after injury so why should a tendon miraculously get better in a day.

A good therapist will know all this and treat the pain. A great therapist will treat both sides just as equally.

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