Tendons, the connective tissues that join muscles to bone are known for being notoriously difficult to treat once injured. The reason for this is that often they are injured through stress or overuse, and compared to muscles they can have relatively poor blood flow, which is essential for healing.
Tendons and muscles work together to move your joints and together are called a contractile unit. As muscles are exercised and gain strength, the attaching tendons are also placed under tension and adapt to this to become stronger. If the load placed on the tissues exceeds their capacity, the tendon fibres can begin to break down and become stiff and painful.
Is my pain related to a tendon injury?
For an accurate diagnosis, you will need to be assessed by a physiotherapist. However, some signs that your pain might be coming from an in issue with a tendon are;
· The pain is quite specific and can be felt over the tendon itself;
· The pain is worse when under stress and improves when rested;
· The pain improves after exercise has started, but it might be worse once you cool down;
· The area around the tendon may feel stiff after periods of rest, particularly in the morning.
How are tendon injuries treated?
When it comes to recovery, tendons are often treated differently to other injuries. While each tendon injury is unique and will require assessment and intervention by a physiotherapist, there are a few general approaches that usually help with all tendon injuries.
Reducing your activity to a comfortable level is the first step to recovery. Complete rest can actually delay healing as the tendon simply becomes weaker and less able to cope with subsequent loads. Your physiotherapist can provide you with a targeted exercise program to aid your recovery. Eccentric exercises, which are exercises that work alongside gravity, have been shown to stimulate tendon healing and strength.
Stretching may aggravate your injury and should be used with caution. Assessment of any biomechanical faults or stresses that are placing undue load on the tendon is also a central component of treatment. Your physiotherapist is able to guide you with your recovery and return to sport to avoid aggravating any injury.
What is a wrist sprain?
Wrist sprains are a general term used to describe any injury to the wrist that doesn’t include a fracture, but is most likely to be a ligament injury. While this can indicate that they are not serious injuries, wrist sprains can be complicated injuries that require supervision and treatment to recover fully.
The wrist refers to the area where the bones of the forearm, the radius and ulna, meet and join the bones of the hand. The wrist is able to twist on itself and allows the hand to move to face palm up (supination) or palm down (pronation). The hand is also able to move up and down (flexion/extension) and side to side (abduction/adduction). To allow such complicated movements, the joint surfaces of the wrist are held together by a series of ligaments. When a wrist is sprained, it is usually these ligaments that have been damaged.
What are the symptoms?
The primary symptom of a sprained wrist is pain with movement of the joint or when taking load, such as when holding a heavy object.
Ligament injuries are given a grading scale to indicate their severity, which can help to guide treatment. Grade 1 refers to a stretching or laxity of the ligament fibres and injuries of this grade usually heal with rest within 2-3 weeks. A grade 2 classification signifies that there has been a partial tear of the ligament fibres and will often need more time and treatment for recovery. Grade 3 tears refer to a full thickness rupture of a ligament and may require splinting or even surgery.
The most common cause of a wrist sprain is a fall onto an outstretched hand. Ligament injuries can also happen gradually through over use, although this is less common.
What is the treatment?
Your physiotherapist is able to help diagnosis a wrist sprain and can help to rule out a fracture. An X-ray might be required and your physiotherapist will perform special tests to help identify exactly which structure has been injured, also giving the injury a grade, to help guide treatment.
How can physio help?
The key to effective recovery for a wrist sprain is ensuring that the right treatment protocols are in place for your particular injury. Grade 1 sprains will recover best with gentle exercises and early strengthening while Grade 2 to 3 injuries may require splinting or even a surgical consultation for repair.
If surgery is the right course for you, your physiotherapist is able to guide you through this treatment pathway, helping you to prepare and recover from surgery to get the best outcome possible.