What is tendinopathy or tendinitis?
If you have ever been told that you have tendinitis, or your tendon has been overused, you might find the following information helpful:
Pain and Pathologic condition of Tendon is generally called Tendinopathy; which means a failed healing response of tendon tissue to an injury. Tendons are the thick fibrous cords that attach muscle to bone. The injury might be sudden like a trauma during sport, fall or accident, or it might happen gradually by repetitive use of the same group of muscles and overloading them, but also surprisingly from under loading the muscles like not using them enough. Because tendons are designed to tolerate a good amount of load, they don’t have large vessels, so they lack good circulation which impairs their healing process compare to muscle tissue.
The term of Tendinitis is commonly used to describe pain and dysfunction following an acute injury; however, tendinopathy does not necessarily accompany inflammation. Inflammation might be present at the very early stage of the injury usually less than 3 weeks, but after that even though it is mentioned as tendinitis, based on histologic studies, there is no actual inflammation in the tendon tissue. The pain from tendinopathy is usually local and present with activity or after loading the tissue. It might be sharp and local. The most common sites of tendinopathy are: shoulder, elbow, knee, and ankle.
Physiotherapy is one of the effective treatments to deal with tendinopathy. Your therapist will design an individualized treatment plan based on your injury, your movement pattern, and also your future risks of reinjury. Exercise Therapy is one of the major components of your treatment plan. Your therapist might also consider using other modalities like Low-level Laser Therapy, or Shockwave Therapy, or IMS
In my practice, I try to design a specific exercise program for my clients. In treating tendinopathies my approach is combination therapy, meaning that based on your symptoms and progression, I might combine your exercise plan with laser therapy, SWT, or intramuscular stimulations, and this is what I have found to be the most effective treatment plan.
1. The Basic Science of Tendinopathy.Yinghua Xu, George A. C. Murrell, Clin Orthop Relat Res. 2008 Jul; 466(7): 1528–1538.
2. Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon. Brett M. Andres, George A. C. Murrell, Clin Orthop Relat Res. 2008 Jul; 466(7): 1539–1554.
3. Novel Approaches for the Management of Tendinopathy Nicola Maffulli , Umile Giuseppe Longo, Vincenzo Denaro, J Bone Joint Surg Am, 2010 Nov 3;92(15):2604-13