Tendon pain and/or injuries are among the most common overuse injuries. Historically, tendon injuries were commonly thought to be a tendinitis, with the “itis” suffix indicating inflammation, hence conventional management was aimed at reducing the inflammatory process with things such as RICE (Rest, Ice, Compress, Elevate) or anti-inflammatory medications or injections. Unfortunately this is commonly unsuccessful, particularly in the long term. What is now understood is that tendon disorders are generally degenerative, as a result of too much stress on the tendon (either from overuse, or from a sudden change in use that traumatizes the tendon), and injury-related, disease-related or age-related changes. Often there can be an anatomical cause for tendon disorders – some people just have a problem with the way they are built or the way they move…and that needs to be addressed. All of these conditions may be associated with a tendon’s lack of ability to properly heal itself.
People with tendon pain often present with1 :
- Pain some time after exercise or, more frequently, the following morning upon rising.
- Pain at rest and initially becomes less painful with use.
- Pain that can “run through” the pain or the pain disappears when they warm up, only to return after exercise when they have cooled down.
- The ability to continue to train fully in the early stages of the injury.
- Localised tenderness and thickening
- Frank swelling and crepitus (grating sound)
The most common tendinopathies we see here at Sports & Spinal Albury are those of the ;
- Rotator cuff
- Tennis elbow
- Golfers elbow
- Tibialis Posterior
Interestingly we find that by the time most of our clients present with a tendinopathy it has become chronic, commonly it is because they have been doing the wrong thing……what is the wrong thing I hear you ask? We have your answer. Below is a list of 10 things not to do with lower limb tendon pain, which can also broadly be applied to the upper limb, courtesy of Professor Jill Cook2.
- Rest completely
- Have passive treatments
- Have injection therapies
- Ignore your pain
- Stretch your tendon
- Massage your tendon
- Be worried about the images of your tendon
- Be worried about rupture
- Take short cuts with rehabilitation
- Not to have understanding of what loads are high for your tendon
The take home message? Exercise-based rehabilitation is the best treatment approach for tendinopathies. So where do you start? Booking an appointment with one of our Osteopaths might be a good place to start. We have Osteopaths available who have completed further education in tendinopathies and may be just what you need to help aid you in your recovery.
Want more information about the do’s and do not’s of tendon pain, click on this link to that blog.
– Dr Vaughan Saunders
B Sc (Clin Sc) M Hlth Sc (Osteo)
1, Brukner P, Khan K. Clinical Sports Medicine. 3rd ed. Sydney, Australia: McGraw-Hill; 20062, Cook, J, 10 things not to do if you have lower limb tendon pain, La Trobe University; 2016