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.