How do we Manage Tendinopathy – What did we learn?

A piece inspired by our seminar attendance.

As many of you would’ve seen, our clinical coordinator attended a very interesting educational evening based on the current research on the management of tendinopathy. This is a very common complaint amongst our patient base and generally affects about 5% of the population. Therefore, it’s increasingly important to be able to rehabilitate these injuries speedily and effectively.

So what is Tendinopathy?

Tendons are the tissues in your body that attach muscle to bone. So, when you contract your muscles, both tendons and bones move also. A very common example is the Achilles tendon, this is found on the heel bone and is attached to the calf muscle, which allows you to move your ankle.

Tendinopathy covers two further terms: tendinitis and tendinosis. Although, we usually don’t tend to differentiate them in general rehabilitation. The “itis”, like most medical terminology suggests inflammation of the tendon. This can be short or long term and can develop after an injury or from repetitive injury such as lifting, as seen in rotator cuff (shoulder) tendinitis or in tennis/golf players who may suffer from epicondylitis. Tendinosis refers more specifically to a degenerative change, where the fibres in the tendon may breakdown, this usually is more long-term and is due to overuse.

How do I know if I may have Tendinopathy?

You may have trouble in joint movement or feel a crackling or grating sensation when you move your joint as well as the muscles around the joint feeling weaker. Sometimes there is redness and general swelling around the joint. This is when you should contact your GHG professional, we are highly experienced in tendinopathy recognition and strive to provide you with the service that aligns with the latest research.

What is the latest research?

 First and foremost, as with anything MSK, we activity modify ensuring that you avoid activities that would provoke further pain and dysfunction. An exercise-based programme is the core of therapy. We avoid prescribing ‘complete rest’ as this is shown to decrease muscle power and therefore the functional properties of the tendon. Mainly, we suggest avoiding heavy loads and repetitive movement.  We follow what is called a “concentric eccentric” training programme alongside your manual therapy.

Big word –don’t worry- let’s explore this!

The concentric phase refers to when you shorten (contract) the muscle, and the eccentric refers to lengthening the muscle. For those who just focus on pulling the weight towards your chest when bicep curling – make sure you are also intentionally lowering the weight slowly – to help lengthen the muscle and preserve the tendon!

Then we have the Shockwave therapy. Shockwave therapy short bursts of sound waves been passed through into the tissues, this is proven to help regenerate the tendon tissue and as a secondary, help with pain relief after treatment. This therapy is adjunct to exercise therapy. It’s important to remember that nothing will replace the effectiveness of an exercise-based therapy.

The new kid on the block is the Laser treatment. More formally known as photo biomodulation therapy, which some of our service users did get a chance to try over the summer. Again, as an adjunctive treatment to manual and exercise therapy, laser sessions have shown to be effective for tendon regeneration and pain relief. Laser does seem to be a friendlier device as you do not have strict rules as to how spaced-out treatments should be, however, it’s still relatively new, so GHG clinicians are keeping a close eye on this one.

If you feel like you may have been experiencing any of the symptoms above or just generally have any queries, get in touch with us at Goodall Healthcare Group.

info@goodallhealthcaregroup.co.uk or click here to book an appointment.