Tendonitis is a condition where tendons become inflamed and stressed. Symptoms of tendonitis can be very painful, with swelling and a soreness deep within the tissue that leads to an inability to perform daily tasks comfortably. One of the most common causes of tendonitis is a significant strain or injury where the tendons are made to elongate or pull past their typical range of motion.
What is Tendinopathy?
Tendinopathy occurs when small tears of the collagen within and around the tendon are caused by long-term overuse. As time goes on, this overuse leads to a deterioration of the tendon that, unlike tendonitis, does not involve significant inflammation.
Inflammation from acute tendonitis usually improves rapidly in response to treatment by medication and anti-inflammatory measures. However, if the injury is caused by tendon tissue deterioration over time, treatment can take a bit longer to take effect, since it focuses on the strengthening of the tendon and regeneration of the tissues.
Braces or splints can also be used to reduce the impact and pressure on the tendon during the healing process. Massage therapy is also a common treatment.
How Physiotherapy Can Help
For both tendonitis and tendinopathy, flexibility and strength training guided by a physiotherapist can begin immediately. An individualized rehabilitation schedule is necessary because every injury is unique and the lifestyle and goals of patients can range.
For the fastest recovery time, carefully follow the instructions of your physiotherapist on what you need to do at home between appointments.
Identifying the cause of the tendon injury is key, along with implementing corrections to the movement or activity that caused the injury. This way, long-term problems with the tendons can be prevented.
Frequently Asked Questions About Tendonitis & Tendinopathy
How can you prevent tendonitis?
1) Decrease or eliminate repetitive or overuse movement patterns
2) Optimize posture
3) Improve technique
4) Maintaining good strength and flexibility in the muscles, joints and connective tissue
Does tendonipathy ever heal?
Yes it can heal. A combination of rest, stretching, manual therapy and modalities are all important to help heal a tendinopathy, however exercise has been shown to be the most evidence based treatment for it. The tendon needs to be loaded gradually in order for it to be able to develop a better tolerance to load/movement. Your physiotherapist will provide you with a personalized exercise program with proper exercise progression.
Can you work with tendonitis?
The short answer is yes, however it depends if your injury will put you at risk of your own safety and the safety of other. Also, continuing to work might delay your recovery depending on what kind of movements are required of you at work. There might be some modifications that your physiotherapist will advise you to do such as maintaining a good posture and proper biomechanics. Modified duties can be an option for some individuals. For certain types of tendonitis, a brace could be of benefit to offload the tension placed on the tendon and disperse the force (i.e elbow brace). A brace can help the individual continue with theirs tasks with less pain. Also, pacing a task can help tremendously too.
What should you do after treatment?
You should listen to your body and see how things feel. It can sometimes take 24-48 hours after a treatment to feel the effects. Write down any observations or comments you would like to share with your physiotherapist and pay attention to you limitations and abilities. Follow the exercises your physiotherapist has provided.
Can stretching make tendonitis worse?
It all depends on the severity of the tendonitis. Proper, gentle and gradual stretching in important to maintain flexibility in the muscles and tendons. However, if the tendon is torn or ruptured, stretching can make it feel worse. You should have your joint properly evaluated by your physiotherapist in order to be prescribed the right exercise and the right amount of stretching.
Is heat or ice better for tendonitis?
Tendonitis is an inflammation of the tendon, therefore heat will only increase the inflammation and potentially increase pain. It is advised to use ice for approximately 15 mins directly on the tendon.
What is the best way to heal tendonitis in the foot?
Depending on what tendon is involved, your physiotherapist will complete a full body and gait analysis of your foot, ankle, legs and hips mechanics. I de tiffing a faulty movement pattern, a weakness in a joint or a lack of mobility somewhere(to name a few), is the first thing to do in the rehabilitation process. An exercise program that will be monitored by your physiotherapist and progressed as needed is key to the client's return to ADLs or return to sport. A combination of manual therapy, mobility and strengthening exercises and the use of a type of modality to calm the inflmmatin should be advised when treating tendonitis in the foot.