Treating Tendon Pain
Tendon pain, and its associated dysfunction, can be a major factor for pushing athletes out of sport, limiting our ability to be independent and simply stopping us from doing all the things we love to do.
For many years, pain linked to tendons has been diagnosed as tendonitis with the suffix -itis referring to inflammation of the tendon.
Historically, treatment for pain in tendons has been anti-inflammatories and time away from exercise and activity.
Recent research however, has focussed attention on the true cause of tendon pain.
Rather than being inflammatory in nature it seems the physiological process involved is more a degenerative process.
Tendons love load.
They love to be stressed and this helps to keep them healthy and functioning properly.
If, however, too much load is applied too quickly (for example, a sudden increase in activity levels or weight gain) the tendon will degenerate.
This degeneration can cause abnormal function, changes to the micro-cellular structure, a lower tolerance for stress in the tendon, pain and abnormal thickening and is more correctly called Tendonopathy.
Tendon pain can stop you from doing the things you love
Tendons are impressively complex structures that need to be able to perform three tasks.
- Firstly, they need to be strong enough to tolerate a high static load
- Secondly tendons need to be able to move while having a load applied to them
- Thirdly, they need to be able to store and release energy in an explosive manner.
These three functions allow us to move, walk, hop, run and jump.
Treatment for Tendonopathy should follow the basic principles of treating any musculoskeletal injury: reduce damaging stress in the tissue and improve the health of the tissue to develop its ability to take the load it is subjected to.
As a Podiatrist, probably the most common case of Tendonopathy I come across is Achilles Tendonopathy.
In this condition pain can occur in the middle of the tendon (mid-substance Tendonopathy) or where the tendon joins the heel bone (insertional tendonopathy).
Treatment of Achilles Tendonopathy must vary depending on where the degenerative changes are occurring.
Our management plan for treating Tendonopathy is always individually tailored to the client and the tendon yet will usually follow the below steps:
- Accurately diagnose the tendon problem (including requesting Ultrasound investigation)
- Develop a plan for managing pain in the tendon
- Reduce the damaging load in the tendon via strapping, activity and footwear modification, gait retraining and appropriate orthotic intervention
- Improve health of the tendon via manual therapies such as Shockwave Therapy tool assisted massage and dry needling.
- Exercises to improve static strength in the tissue
- Once pain and strength improves, modify exercises to stress the tendon while moving
- Prescribe exercises to work on explosive power (plyometric exercises)
The management of Tendonopathy can be a long term project that requires commitment to the treatment regime.
Contact us on 8330 0004 or Book Online
I would love to talk to you about how we can help you build an amazing life from the feet up
Anthony Robinson
Director of Complete Podiatry