What is Tendinopathy?
Tendinopathy affects the tendons, and the tendons connect muscles to bones. Tendinosis is another name for tendinopathy. It is a condition where the collagen in the tendons breaks down. It is not the same condition as tendonitis, because tendonitis is inflammation of the tendons. Research shows that tendinopathy can cause tendonitis. Both conditions occur when the tendons become stressed and overused. Additionally, age and reduced muscle tone can also contribute to the condition. Usually, tendinopathy affects the Achilles tendon, rotator cuff tendons, patellar tendon, and the hamstring tendons.1 In many cases, the condition is a result of improper sports technique. Patients who regularly participate in sports should work with a trainer and practice proper warm-up and cross-training. Repetitive stress injuries are a major factor. Fortunately, there are multiple methods of treatment available. Treatment options range from home treatment to surgery, and every case is different.2
Symptoms of Tendinosis
There are a number of symptoms that are indicative of tendinosis. For example, the patient might experience swelling, pain, and stiffness in the area around the affected tendon. Further, there can be a grating or crackling sensation in the affected area. A lump may develop along the tendon, and the area can become weak. Over time, the tendon might completely tear. As a result, the patient may be able to feel a gap along the tendon. The patient will experience increasing movement impairment as the condition persists. In some cases, only the tendon sheath degrades. When only the tendon sheath is damaged, the condition is known as tenosynovitis. Patients have to seek treatment immediately so that the tendon is not too damaged. Symptoms will worsen when the condition is not treated. Repetitive stress injuries are susceptible to further degradation with continued aggravation.3
Tendinopathy in the Leg
Quadriceps tendinopathy, Achilles tendinopathy, high hamstring tendinopathy, and patellar tendinopathy are all variations of tendinosis that affect the leg. Leg tendinopathy is usually caused by running, which is a repetitive stress activity. Patients who do not allow their bodies to properly recover between exercise stressors are more likely to experience lasting damage. Furthermore, prolonged sitting activities such as rowing can cause high hamstring tendinopathy.4 Additionally, jumper’s knee is another name for patellar tendinopathy. Patellar tendinosis is usually caused by jumping and landing activities. Excessive jumping and landing strains the tendon in the knee, and repetitive stress can damage the knee faster than the body can naturally repair it. Symptoms are often related to the damaged area, so patients can usually tell which tendon has begun to degrade. Tendinosis can affect one or both legs.5
Rotator Cuff Tendinopathy
Another part of the body commonly affected by tendinosis is the rotator cuff in the arm. There are several factors that contribute to rotator cuff tendinopathy. In many cases, damage to the rotator cuff is not caused by exercise. Instead, the awkward positions and static postures that many office workers hold can cause damage. Patients who work with direct load bearing and repetitive arm movements can also develop rotator cuff tendinopathy. Repetitive arm movements are often performed in sports, and patients who regularly do heavy work are also prone to injury. For example, baseball players might develop rotator cuff issues due to the repetitious arm movements they perform regularly. Other risk factors for tendinosis are advancing age, low flexibility, and weight. Even a patient who is otherwise very healthy will become injured if they do not use proper warming up and resting techniques.6
Fortunately, home treatment for tendinopathy works for many patients. Typically, NSAIDs are not used to treat tendinosis. Patients should try the RICE method: rest, ice, compress, and elevate. During recovery, it is also important that the patient continues to practice low-impact exercises. For example, patients who are recovering from Achilles tendinopathy can benefit from swimming. A physical therapist can help patients find safe exercises to do during recovery. The patient’s doctor might recommend a physical therapist, and the physical therapist can create an exercise plan based on the type of tendinosis that the patient has. Unfortunately, there are cases where the patient needs surgery to fix the tendon. If the patient has not seen any improvement in the tendon, their doctor will suggest tendon repair surgery. Recovery from surgery will likely include three months of physical therapy in order to rebuild the patient’s strength.7
Patients can also seek chiropractic care to treat their tendinopathy. Chiropractic care is a form of natural medical care, and chiropractors do not usually suggest medications or surgery unless they are necessary. The chiropractor may use medical imaging, study the patient’s medical history, and ask about the patient’s exercise practices to diagnose tendinosis. Then, the chiropractor will perform physical adjustments on the patient, and the chiropractic adjustments should strengthen the tendon and alleviate pain. The chiropractor may also use medical taping to provide support to the affected area. Additionally, chiropractors will suggest exercises for patients to try at home. Often, chiropractors work with physical therapists to create a rehabilitative exercise program for the patient. Some patients will begin to see the results of chiropractic care within weeks of starting treatment, and their tendinosis might be cured within months.8
In many cases, chiropractors work with massage therapists to treat patients. Some chiropractors and massage therapists even share an office. Massage therapy is a complementary treatment method. Patients who suffer from tendinopathy will often receive deep friction massage, because both physical therapists and chiropractors will recommend it. Deep transverse friction massage stimulates cell activity in the connective tissues. It promotes the generation of new fibers in the degrading tendon. Massage is also a natural pain reliever, and it helps the body heal itself. Sports massage is a style of massage that is often used to treat tendinopathy and similar conditions. Many professional athletes have teams of chiropractors, physical therapists, and massage therapists to treat the injuries that they sustain. Even trained professionals can become injured, and seemingly simple treatment methods like massage therapy can help.9
1, 7, 9 https://www.healthline.com/health/tendinopathy
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