Tendinopathy
Tendinopathy is a degenerative change within a tendon in the body.
We used to call this tendinitis but, with new research and more evidence, we have learned this is not a problem just caused by inflammation.
What is Tendinopathy?
Tendinopathy is a condition where tendons that join the muscles to bones undergo changes in structure that make them weaker. Tendons transfer load from the muscles to the bone, as well as store and release energy, and any weakness can cause pain.
Tendinopathy is a common complaint in sports that involve explosive movements like running and jumping, however, it can easily occur in older people.
Tendinopathy can occur in the main tendon structure (mid-portion tendinopathy) or where the tendon joins the heel bone (insertional tendinopathy).
What does tendinopathy feel like?
New pain science research has shown us that pain levels and tendon damage don't usually correlate and that each person’s experience with Tendinopathy will be slightly different.
Initially, Tendinopathy may feel like general soreness in the tendon that settles quickly with activity.
Gradually, the soreness begins to take longer to settle and develops into a true sensation of pain in the tendon first thing in the morning and throughout the day.
With continued overloading, the tendon becomes swollen and very painful to use and touch.
What causes Tendonopathy
Tendinopathy is often caused by overuse and overloading of a tendon. This causes damage to the tendon fibres and alters its ability to tolerate stress. Once this damage occurs, the tendon can then develop an abnormal healing process.
Contributing factors may include:
- a sudden change in activity (frequency, intensity, duration, surface)
- changes in footwear
- deconditioning from a previous injury,
- poor biomechanics (the forces associated with the way you move and function) as well as
- reduced muscle flexibility and joint range of motion.
If we look at an ultrasound or MRI of the damaged tendon we may see small “tears”, this is a normal finding with tendinopathy.
DON'T think of a tendon with tendinopathy like a rope which is about to snap!
Tendons with tendinopathy still contain a lot of normal, healthy tissue.
Instead, DO think of a tendon with Tendinopathy like a doughnut: the hole of the doughnut is the small section of degenerated tissue and the good, yummy part of the doughnut is the healthy tendon tissue.
We are here to help your tendinopathy
Tendinopathy does not generally settle without assessment and intervention. Initially, it is important to diagnose the problem and establish its severity. An Ultrasound may be required to review the tendon structure at this time.
The goal of treatment is to safely strengthen the healthy tissue surrounding the degenerative tissue.
Your Complete Podiatrist will assess your activity levels, biomechanics, and training loads to determine how the tendon is being overloaded. Once this is complete, we will determine an appropriate management plan and timeframe for improvement.
Your management plan will include strategies to manage your pain including Shockwave Therapy, soft tissue massage, dry needling, reduced loading of the tendon in the initial phase, and a progressive exercise program to build strength and capacity back into the tendon.
Foot orthoses may be required to shift the loading forces contributing to your tendon pain.