Tendonopathy and Tendonitis. What’s the Treatment?
A tendon is a long elastic collagen material which attaches muscles in the body to the bones. They are lever points which transfer energy to allow us to move. Tendon overuse injuries can occur anywhere in the body. The most common regions that tendon issues occur are the Achilles tendon, the patella tendon, the rotator cuff tendons and tendons of the elbow.
Historically many names have been used for tendon pain including tendonitis, tendinitis, tendinosis and tendinopathy. The term tendinitis was initially used as it was believed that tendon pain arose from inflammation of the tendon hence the medical suffix for inflammation “itis”.
The most current and scientifically correct term is tendinopathy. It is now understood that inflammation occurs in the very early stages within 24 to 48 hours of the tendon being exposed to stress. Inflammation is not a significant feature of the long-term problem of tendon pain.
When the tendon is exposed to stress from mechanical loading such as exercise or repetitive occupational work the tendon goes through a period of micro-degeneration/breakdown. The body’s natural response is to rejuvenate the tendon through laying down new tissue.
Tendonopathy occurs when there is an imbalance between the tendon breakdown and the tendon rejuvenation. If the tendon cannot rejuvenate due to excessive mechanical loads from exercise or occupational work, the tissue cannot repair. The tendon repair process is irregular leading to poor quality tendon tissue and pain.
Physiotherapists are experts in diagnosis of tendinopathy. As there is very limited inflammation within the tendon, the best form of treatment is an exercise program. Exercise can be prescribed to stimulate tendon healing without overloading the tissue and creating further damage.
Your Physiotherapist will help you balance the loads on your tendons. This may mean modifying your sport and work habits. Specific exercise rehabilitation can be prescribed to stimulate blood flow and increase rejuvenation of the tendon tissue. A good rehab program will reduce your pain and see you back doing the activities that you enjoy.