A tendon injury commonly occurs when you overload the structure by doing a bit too much of a particular activity. A popular example we see in the clinic is a person who is new to exercise and over exerts themselves in their workout. This is like your weekend warriors who is preparing for a marathon but does not have a gradual running program. The tendon connects muscle to bone and it can become irritated when it cannot handle the heavy load of the physical activity. We often heard of terms like tennis elbow, golfers elbow, de quervain’s tenosynovitis, Achilles tendinitis and patella tendinitis. These are all types of tendon injuries. People with tendon injuries typically complain about localized pain and stiffness in the morning. Tendons usually have a warm up effect and can be better with movement. Here are 5 facts you should know when dealing with a tendon injury.
1. Don’t completely rest the tendon: Some rest is necessary for initial stages of recovery however complete rest can be harmful for recovery. Your tendon pain may feel better with rest however it reduces the load tolerance of the tendon. It can lead the tendon to become stiff and weak in the long term. Research have shown that we should introduce small amounts of load to begin making beneficial adaptive changes to the tendon. It is important to note that you should contact a physiotherapist or a health care professional before introducing any gradual loading program for an injured tendon.
2. Consult with a physiotherapist: Our physiotherapists are experts at managing tendon injuries. We understand the pathological process of a tendon injury. This will allow us to prescribe the correct exercises to appropriately load your tendon and set you up to make a full recovery. Tendon injuries can make it very painful for you to move and go about your daily activities. Our physiotherapist will be able to provide manual therapy and a light exercise rehab program to help alleviate the tendon pain.
3. Avoid stretches to the tendon: Stretches may feel good for the body but it can add additional compressive load the tendon which can slow the recovery process. A better method is to perform isometric exercises. This is a static muscle contraction exercise where the muscle length does not change when placed under tension. A physiotherapist will be able to guide you on the appropriate isometric exercises for acute tendon injuries.
4. Avoid using imaging as the source of your diagnosis: Tendon pathology that is shown on imaging does not always correlate to damage. People can have irregularities in their scan be without pain. For this reason, it is difficult to say that the tendon pathology on the scan is responsible for the pain you’re experiencing with your physical activity.
5. Don’t rush tendon rehabilitation: Tendon injuries can time to completely recover to their pre-injury capacity. It takes time to build up tendon strength. It usually takes over 3 months to rehabilitate a tendon injury. If you rush the rehabilitation and jump back into your sport then you can risk re-injuring your tendon.
References:
Cook, J.L., 2018. Ten treatments to avoid in patients with lower limb tendon pain. British Journal of Sports Medicine, 52(14), pp.882-882.