Tendinopathy

Tendinopathy , also known as tendinitis or tendonitis, is a type of tendon disorder that results in pain, swelling and impaired function. Tendons are strong, rope like tissues containing collagen protein. Thy connect your muscles to your bones. Tendinopathy also called tendinosis, refers to the breakdown of collagen in a tendon. Tendinopathy most common affects the wrist flexors, wrist extensors, rotator cuff, patellar and achilles tendons. It is characterized by a clinical syndrome of burning pain in addition to reduce flexibility and range of motinn, swelling and loss of function and it is theorized that it is caused by an abnormal healing response within the tendon itself . Both tendinopathy and tendonitis are often caused by overuse of or sudden stress on a tendon. Aging and lack of muscle tone can also play a role in the development of tendinopathy.

Treating tendinopathy usually starts with giving the injured area plenty of rest. But it’s important to still be lightly active to maintain your strength and overall health. If your Achilles tendon is affected, for example, consider opting for low-impact activities, such as swimming. 

If you can’t avoid putting repeated stress on the area due to your job requirements, try to shoot for 1 minute of rest for every 15 minutes of work, or 5 minutes of rest for every 20 to 30 minutes. 

You can also try the RICE method, which is often very effective for tendon injuries:

• Rest. Try to stay off the affected body part as much as you can.
• Ice. Wrap an ice pack in a light towel and hold it to the affected area for 20 minutes. You can do this up to eight times a day.
• Compress. Wrap the area in an elastic bandage, making sure it’s not too tight.
• Elevate. Keep the affected area raised on a pillow or other device. This can help to reduce any swelling.

A physical therapist can also help you to rebuild strength and stimulate tendon healing through gentle exercises. Your doctor can give you a referral to a qualified physical therapist. 

There are several techniques that a physical therapist might use to treat tendinopathy, but two common ones include:

• deep transverse friction massage, a type of connective tissue massage that can help to stimulate cell activity and generate new collagen fibers
• eccentric exercises, which force your muscles to lengthen while they contract, rather than shorten

• Eccentric exercise demonstrated positive effects in reducing pain and improving function. Suitable for long term management and improvement in function. This is consistent with existing literature.
• Isometric exercises are effective for short term pain reduction
• Eccentric exercise is likely effective due to neuromuscular adaptations, collagen synthesis and pain habituation. Optimal protocol is unknown.
• Shockwave may be a useful treatment modality in reducing pain and improving function however there aren’t enough high quality studies to draw firm conclusions.
• There is not enough evidence to draw firm conclusions about laser therapy.
• Ultrasound was shown to be no more effective than placebo