This time of year we have many patients coming to see us as part of their training for marathons, trail runs and many other events and sports. As this training is putting an increased load on your muscles and tendons it is inevitable that we see a lot of people presenting to us with tendon pain.
Tendinopathy is an all-encompassing term that is used to describe several conditions affecting tendons and surrounding tissues in response to overuse. You may have heard of tendinitis, tendinosis or even tensosynovitis. These terms all can be grouped under the ‘Tendinopathy’ category. Although sounding quite overwhelming, they are fairly common and treatable if you follow the advice from your health professional.
There are several ways to approach a tendinopathy. Usually it depends on the onset of the injury, how long you have had it for and how much tissue may be damaged. In most cases though, we will aim to get you pain free at rest within a few weeks. This may include treatment with us here at Rebalance Myotherapy along with some at home prescriptive exercises for you to do. We would also get you to refrain from any aggravating factors during this time.
A recent Cochrane systematic review evaluated the effectiveness of different types of treatment applications ranging from Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen, physical therapy, corticosteroid injections, right through to surgery and stem cell treatment.
The evidence found in these studies showed that topical or oral NSAIDs were affective within the short term (7-14 days), however there was no clear evidence that ongoing use of NSAIDs is effective in the treatment of tendinopathies. As this is usually a go-to for the general public, we recommend that this only be used in the first two weeks after the injury to control pain and swelling.
Physical therapy is used frequently in the treatment of tendinopathies. This is what you would see us for and can include modalities like dry needling, soft tissue mobilisation, prescriptive stretching and strengthening exercises. The main focus of the exercises we will give you is to eccentrically contract the muscle and tendon complex. These programs work particularly well for Achilles tendinopathy. Eccentric loading of a muscle is the process of contracting a muscle as it “lengthens” ie. Lowering your heel off a step slowly.
Corticosteroid injections are another common treatment for tendinopathy. Most of the findings with this treatment are positive pain relief in the short term, up to 6 weeks. However, long term effectiveness has not been proven.
Surgery for tendinopathies is rare and can be performed as a last option usually after all non-operative measures have been taken.
Although they may take some time, most tendinopathies will heal with conservative treatment within 6-12 weeks.
Hopefully this information has been helpful to you all out there who are training for upcoming events! Please feel free to contact the clinic on 0418 709 904 if you would like any more information or advice.