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What is a tendinopathy?

Published: 28 November 2017 - Clinical Conditions

Image of an ankle

Tendinopathies are common in both athletes and people who are new to exercise. They can be debilitating and prevent you from achieving your fitness goals. Luckily, Australian physiotherapists are at the forefront of both tendinopathy research and management.

What is a tendinopathy?

A tendinopathy is a general term for conditions that affect the structure and function of a tendon. Tendon injuries predominantly occur from an acute increase in tensile or compressive loading e.g. jumping sports like basketball, volleyball, running, etc

Tendinopathies characteristics include:

  • Pain is localised to a tendon which can be pointed to with one or two fingers
  • Tendons are tender when palpated
  • The area is stiff and painful in the morning
  • The area feels better with movement e.g. experiencing a ‘warm-up effect’ after waking

Is your tendon Inflammed?

Although the tendon may not be inflammed, there’s a lot of research that suggests inflammation has likely played a role in development of the tendinopathy.

Anti-inflammatories (e.g. ibuprofen) can be effective in relieving pain when taken for short durations upon advice of your physio or GP. On the other hand corticosteroid injections can reduce pain in the short term however may actually result in worsening of the tendon structure and function in the long term.

How does a tendinopathy occur?

Tendinopathies primarily occur due to an acute increase in training load. For athletes, this can occur after returning to sport after a period of time off, e.g. preseason training. It can also occur in already active athletes who increase the amount or intensity of games, practices, or training sessions they have during a week.

For inactive or sedentary individuals, this can occur when a person decides to pick up exercise and performs too much, too soon.

What you should and shouldn’t do if you have a tendiopathy

What not to do if you have a tendinopathy 

  • Rest completely! Some rest is necessary to manage a tendinopathy, but complete rest can be even more deterimental to the tendon health!
  • Stretch your tendon. If you feel tight, massage the muscle above or below the tendon.
  • Be worried about the images of your tendon. Pathology (i.e. degeneration) on imaging is NOT equal to pain – pathology is common in people without pain.

What to do if you have a tendinopathy

  • Modifying load by reducing the amount of exercise to allow the pain to settle.
  • Consult your physio to commence a progressive strength training program to rehabilite and restore the tendons energy storage abilites.
  • Be patient - tendinopathies can take weeks to months to resolve!

Please note that these are general principles and there are instances when other adjuncts interventions are very appropriate in the management of tendinopathy.

Contact your local Back In Motion practice to discuss whether physiotherapy could help you!

Author

This blog has been written by final-year physiotherapy student Mo Hamdon. Mo recently completed his clinical elective placement with Back In Motion Blackburn. We wish Mo all the best as he looks to enter the physiotherapy workforce next year (sadly for us in Australia, this will be in Mo's homeland, Canada).

References

Coombes, B. K., Bisset, L., & Vicenzino, B. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. The Lancet, 376(9754), 1751-1767.

O'Neill, S., Watson, P. J., & Barry, S. (2016). A Delphi Study of Risk Factors for Schilles Tendinopathy – Opinions of World Tendon Experts. International journal of sports physical therapy, 11(5), 684.

Rees, J. D., Stride, M., & Scott, A. (2013). Tendons–time to revisit inflammation. Br J Sports Med, bjsports-2012.

http://www.tendinopathyrehab.com/blog/tendinopathy-updates/9-tendinopathy-truths-that-you-must-know-version-2

http://semrc.blogs.latrobe.edu.au/10-things-not-to-do-if-you-have-lower-limb-tendon-pain/