Physiotherapy and "tendonitis"
Tendon injuries are among the most common overuse conditions that present to us as doctors and physiotherapists. The use of the traditional term “tendonitis” has been phased out due to the lack of inflammatory cells associated with the condition. The use of the terms “tendinosis” or “tendinopathy” has been deemed to be more accurate, indicating a pathological collagen breakdown rather than an inflammatory process.
Diagnosis
- often a change in exercise regime or an increased workload has resulted in either an acute, or more often an insidious onset of pain;
- pain is often reproduced with full stretch, or resisted contraction of the affected tendon;
- local tenderness on palpation of the tendon;
- active, tender myofascial trigger points in muscle(s) relevant to the tendon;
- pain on functional testing (for example squats for the patella tendon, single leg heel raise for the achilles tendon, etc.)
Treatment
The multifactorial causes of tendinopathy suggest we need to address several issues in these cases. Certainly patient education is important to encourage compliance and understanding of their condition and treatment program. Physiotherapy treatment will involve combinations of the following…
- Relative rest from the aggravating activity;
- Taping or bracing to unload the tendon, as well as addressing any biomechanical abnormalities and muscle imbalances;
- Massage, transverse frictions, and myofascial release;
- Eccentric muscle strengthening;
- As a last resort, local corticosteroid injection.
Anyone suspected to have an overuse tendon injury should be referred to a physiotherapist for a thorough assessment and treatment. As usual, there is no substitute for early diagnosis and intervention.
I hope this summary will help you or someone you know. As always, we are here at The Physio Nook to help out with any musculoskeletal disorders you may have, tendons or otherwise! Feel free to call us, email, or drop in for a great service.
Paul Woodward
Principal Physiotherapist
The Physio Nook.
- often a change in exercise regime or an increased workload has resulted in either an acute, or more often an insidious onset of pain;
- pain is often reproduced with full stretch, or resisted contraction of the affected tendon;
- local tenderness on palpation of the tendon;
- active, tender myofascial trigger points in muscle(s) relevant to the tendon;
- pain on functional testing (for example squats for the patella tendon, single leg heel raise for the achilles tendon, etc.)
Treatment
The multifactorial causes of tendinopathy suggest we need to address several issues in these cases. Certainly patient education is important to encourage compliance and understanding of their condition and treatment program. Physiotherapy treatment will involve combinations of the following…
- Relative rest from the aggravating activity;
- Taping or bracing to unload the tendon, as well as addressing any biomechanical abnormalities and muscle imbalances;
- Massage, transverse frictions, and myofascial release;
- Eccentric muscle strengthening;
- As a last resort, local corticosteroid injection.
Anyone suspected to have an overuse tendon injury should be referred to a physiotherapist for a thorough assessment and treatment. As usual, there is no substitute for early diagnosis and intervention.
I hope this summary will help you or someone you know. As always, we are here at The Physio Nook to help out with any musculoskeletal disorders you may have, tendons or otherwise! Feel free to call us, email, or drop in for a great service.
Paul Woodward
Principal Physiotherapist
The Physio Nook.