• Why your tendon isn’t improving | Tendinitis/Tendinopathy

  • Tendon pain such as Achilles Tendinopathy, Tennis Elbow, and Rotator Cuff Tendinopathy often get a bad rap with poor improvements and outcomes. Luckily, we have done the research for you and have the answer to why your’s might not be improving

    tedniopathy tendinitis treatment

    There is a huge amount out there on what you should do if you have a tendon pathology, including:

    • Cortisone injections
    • Rest
    • Ultrasound, PRP injections, Shockwave therapy
    • Physio rehab
    • and more

    But the thing is, to know how to get it better, you need to first understand the pathology. So, here is a simple explanation that will make the fix make a whole lot of sense.

    What is a tendinopathy

    Tendinopathy used to be called tendinitis but they found many years ago that they are not very inflammatory at all. Because of this they took out the “itis” and put in “opathy” which means dysfunction.

    A tendinopathy occurs when the tendon adapts the wrong way to overload.

    When a tissue is stressed when used a lot it normally adapts and strengthens itself over 72 hours. BUT. If a tendon doesn’t have this amount of time an dis loaded again within that healing/adaptation cycle, you add stress to half-healed stress. Repeat this over and over and eventually, the tissue thickens and becomes a tendinopathy. This is referred to as a tendinosis on scan results.

    So, why is my tendon now healing?

    The reason it hurts is that the fiber make-up in the tendon has changed. Resting the tendon, using painkillers or getting a cortisone injection may ease the pain – but it will not force a change to the tendon fibers. It won’t get rid of the dysfunction that developed from the initial overload.

    Here is how to get rid of the dysfunction

    Recent evidence and expert opinion all conclude that tendons do adapt to load and with the right load, they adapt in the right way

    1. There is strong evidence that tendons are highly responsive to loading exercises. However, they have to be loaded the right way with the right magnitude.
    2. An effective rehab period for the tendon should apply a high loading intensity over at least 12 weeks, if not longer

    Conclusion

    Load the tendon the right way and follow your physios advice. Passive treatment does not work well in the long term and you do need to stick with the active rehab exercises – there is no “quick fix”.

     

    References:

    Sports Medicine Open article