Have you been struggling to get over a bad case of tendonitis? Are you frustrated with how long it takes to recover from a tendon injury? At Rose City Physical Therapy, our physical therapists use the current best evidence to manage acute and chronic tendon injury to optimize your recovery.
A tendon is a connective tissue that attaches a muscle to a bone. A tendon helps to move our bodies by transmitting forces from muscle to bone. Tendons also function to resist force, including high speed and high tensile forces.
When a tendon is injured, it can impact our ability to perform the most basic activities to the most advanced. Fortunately, our team of physical therapists can help identify the type of tendon problem you are experiencing and give you the tools to get back to doing what you’ve been avoiding.
Request an appointment today, and let us help guide you back to health!
What are the different types of tendon injuries?
There are a lot of possible causes for your painful tendon. Tendonopathy describes any problem with a tendon, including disease, injury, or disorder. Collagen is the main structural protein in tendons, and collagen breakdown is often the underlying reason for a tendon disorder.
The role of a tendon is to transfer energy from a muscle to a bone and to absorb/resist tension caused by prolonged positions and forceful/fast movements of the body. These high levels of stress can lead to collagen breakdown and injury.
The most common types of injuries to a tendon include:
- Tendonitis: Tendinitis is an inflammation of a tendon. Acute injuries, including small or partial tearing, can result in an inflammatory response. Most acute tendon injuries heal on their own with some modification of function as they move through inflammation to tissue repair.
- Tendinosis: Tendinosis describes a dysfunctional tendon and typically does not specify the pathological process, but is generally used to describe a tendon injury at least six weeks old or even more chronic, as research has concluded that most overuse tendon pathologies do not have inflammatory cells. These disorders involve a collagen breakdown.
It is important to note that overuse tendon disorders often take a long time to heal because rebuilding collagen is a slow process. Treating degenerative collagen with anti-inflammatory medication, such as corticosteroid injections or oral medications, can impair healing!
- Tenosynovitis: This condition is often a result of overuse and is due to inflammation of the synovium between a tendon and its surrounding synovial sheath (i.e., a thin layer of tissue surrounding a tendon).
- Tendon tears and ruptures: A tendon tear and rupture are a partial, the former, or complete, the latter, tear of your tendon. Most tears are caused by an injury during sports or a fall.
In addition, ruptures can be acute and chronic.
- Acute tendon rupture. This type of injury is a one-time event. It leads to immediate pain and reduced function. Bruising and swelling are likely.
- Chronic tendon rupture. This type of injury is often the result of a partial rupture that worsens over time. An untreated acute rupture usually causes it.
Lumping all tendon injuries into the same category and the same treatment plan is likely the reason for the need for improvement in some people’s experience. Fortunately, our team of therapists can not only distinguish between the different types of problems, but we can also guide you through an individualized program to achieve the best possible outcome!
How physical therapy can help your tendons
At Rose City Physical Therapy, we will conduct a thorough evaluation that includes learning how long you have been dealing with your injury, which will help us identify the type of condition you are dealing with. Once we know this information, we will design a program tailored to your needs.
We will likely recommend an active rehabilitation program focusing on gradually loading the tendon. Loading means the cumulative amount of exercise you’re doing and can be modified by adding repetitions, sets, resistance, duration, and speed. The goal of tendon rehabilitation is to gradually progress the exercises to challenge the tendon without irritating it further.
Tendons will alert you to overtraining by getting worse and worse while you are exercising or having more pain 24 hours after exercising. Pain worsening during exercise is a clear sign the tendon is not ready for that particular exercise/activity. Typically, the pain will improve as the tendon warms up, so if it worsens, it is important to stop immediately.
When you notice your pain is worse 24 hours after exercise/activity, it means you were trying to push too far too fast. It is a reliable way to know when it is safe to progress again, and if you try to force things, you will only end up delaying your recovery.
Is rest the best option?
It is far too common for the medical community to recommend rest, ice, and anti-inflammatory medication for all tendon injuries. This strategy is ineffective at best and detrimental at worst.
Resting tendons is not the most effective strategy and may delay your recovery. Tendons withstand large forces, and resting them can weaken them further and make you more susceptible to re-injury. Our physical therapists can teach you how to safely load your tendon to keep it strong while it heals.
Ice is okay if used for pain relief, but blood flow is crucial for healing; hence, heat may be a better choice for healing assistance. Too often, people use old strategies that don’t help the condition heal faster and may inhibit recovery based on recent evidence. Tendons, in particular, don’t like the cold when you are about to use them; this is a big reason why people warm up before activity and feel stiff in the mornings. Cold tendons cannot respond to normal stresses from activity as well as warm tendons.
Anti-inflammatory medications can inhibit tendon healing and recovery and are often recommended only for painful, acutely injured tendons as they modulate pain. Fortunately, our physical therapists can help identify the type of tendon issue you are having and, most importantly, the most effective steps you need to take to resolve it!
Request an appointment at Rose City Physical Therapy today!
At Rose City Physical Therapy in Portland, OR, our physical therapists are experts at treating tendon-related injuries. We have proven success with treating tendon disorders and can help you resolve your problem once and for all!
Call today to schedule an appointment with one of our specialists!