Tendinopathy

Tendon injuries can develop in many different parts of the body.

Tendinopathy describes two conditions that are likely to occur together: tendon inflammation, known as tendinitis (or tendonitis), and tiny tears in the connective tissue in or around the tendon, known as tendinosis.

What is a Tendon Injury?

Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually it is the result of many tiny tears to the tendon that have happened over time.

Health professionals may use different terms to describe a tendon injury. You may hear:

Tendinitis (or Tendonitis): This actually means “inflammation of the tendon,” but inflammation is rarely the cause of tendon pain.

Tendinosis: This refers to tiny tears in the tissue in and around the tendon caused by overuse.

Most experts now use the term tendinopathy to include both inflammation and microtears. But many doctors may still use the term tendinitis out of habit.

What Causes a Tendon Injury?

The best results occur with early diagnosis and intervention.

Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or ageing. Anyone can have a tendon injury, but people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon.

A tendon injury can happen suddenly or little by little. You are more likely to have a sudden injury if the tendon has been weakened over time.

What are the Symptoms of Tendinopathy?

Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.

The pain may get worse when you use the tendon.

You may have more pain and stiffness during the night or when you get up in the morning.

The area may be tender, red, warm, or swollen if there is inflammation.

You may notice a crunchy sound or feeling when you use the tendon.

The symptoms of a tendon injury can be a lot like those caused by bursitis.

How is Tendinopathy Treated?

In most cases, you can start treating a tendon injury at home. To get the best results, start these steps right away:

Rest the painful area, and avoid any activity that makes the pain worse.

Apply ice or cold packs for 20 minutes at a time, as often as 2 times an hour, for the first 72 hours. Keep using ice as long as it helps.

Do gentle range-of-motion exercises and stretching to prevent stiffness.

Have your biomechanics assessed by a sports physiotherapist or podiatrist.

Undertake an Eccentric Strengthen Program. This is vital!

Persisting tendon injuries are best managed by a sports physiotherapist. Researchers have found that tendon injuries respond differently to muscle injuries and can take months to solve or leave you vulnerable to tendon ruptures, which usually require surgery.

This has two important issues:

Ensure you have an accurate diagnosis.

Ensure that your rehabilitation is targeted at either the muscle injury or tendinopathy.

How to Return to Sport

As soon as you are cleared by your physiotherapist, you can return to your activity, but take it easy for a while.

Don’t start at the same level as before your injury. Build back to your previous level slowly, and stop if it hurts.
Warm up before you exercise, and do some gentle stretching afterward.

After the activity, apply ice to prevent pain and swelling.

If these steps don’t help, you may require a re-visit to your physiotherapist. It may take weeks or months for a tendon injury to heal. Be patient, and stick with your treatment. If you start using the injured tendon too soon, it can lead to more damage.

To keep from hurting your tendon again, you may need to make some long-term changes to your activities.

Try changing your activities or how you do them.

If exercise caused the problem, check your technique with a coach or sports physiotherapist.

Always take time to warm up before and stretch after you exercise.

Common Tendinopathies

Achilles Tendon Rupture

Achilles Tendonitis / Tendinitis

Adductor Tendinopathy

Bicep Tendonitis

Carpal Tunnel Syndrome

de Quervain Tenosynovitis

Gluteal Tendinopathy

Golfers Elbow

Muscle Strain (Muscle Pain)

Overuse Injuries

Patella Tendonitis (Tendinopathy)

Rotator Cuff Calcific Tendinitis

Rotator Cuff Tear

RSI – Repetitive Strain Injury

Shoulder Impingement

Shoulder Tendonitis

Swimmer’s Shoulder

Tennis Elbow