Tendinopathy: What is it and why do we get it?

A Tendinopathy is a term used to describe damage to a tendon (the connective tissue that binds our muscles to our bones). A tendinopathy will present with pain and often times weakness around the joint that it attaches or crosses and is typically worsened by excessive use of the muscle or group of muscle that it is connected to. It is known to be a result of overuse or overloading of the muscle in a short period of time that creates a lot of tension on that tendon and creates repeat micro-trauma.

A well-known example of a tendinopathy is ‘Tennis Elbow’ where the origin of the common extensor muscles from the wrist/fingers is aggravated because of excessive gripping or lifting. The pain itself presents at the elbow because that's where the tendon is, however the cause is from an overload of those muscles that are needed to grip or lift.

The pain from a tendinopathy typically will be worse when at rest, before or after activity, but then can ‘warm up’ during so it is not as bad. People often find that first thing in the morning it is worse as they get out of bed, particularly with lower limb injuries such as Achilles (heel) and patella (knee) tendinopathies.

The treatment for such an injury is multifactorial and initially it should be to look at what the cause was. Was it a recent increase in running load, or starting up back on the tools after a month’s holiday or doing deadlifts for the first time. Quite often there is a history of a sudden increase in some form of activity that we can relate to the onset of the injury. Once we have identified this we can reduce the load of that specific factor and begin to break down what/where we need to strengthen and mobilise better to be more tolerating of that movement. That may mean that we need to get a joint moving more freely so that the muscles around don’t have to work as hard. Also we need to identify which muscle is responsible for that movement and begin to strengthen it as best we can without increasing damage to that tendon.

A good example of this is the Rottnest Swim - imagine the swim is coming up and a swimmer panics about not having prepared enough so begins to swim everyday without having built up their load over the last few weeks/months. This sudden increase in load places stress on the muscles crossing the shoulder and all of a sudden they start noticing some soreness in the back of the shoulder. We know that we need to reduce the swimming load to take the pressure of those muscles and then we also need to make sure the shoulder, thoracic spine and neck are all mobile and not super stiff and tight. Then we need to begin to isolate the muscles around the shoulder and give that person a comprehensive strengthening program to ensure that the muscles are able to withstand the level of force, and endurance required to perform that level of activity.

Tendinopathy is a tricky diagnosis to manage if it is left for too long so it is really important to get a skilled health professional to have a look at your injury, your technique and any other factors involved that may be contributing.

Do you have any aches or pains that you want to get checked out? Book in online here to see one of our Physio's today, or call us (08) 9448 2994.

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