A tendon marks the transitional portion of a muscle as it attaches to bone. In comparison to muscle, tendons are less elastic and have a relatively limited blood supply.
If repeatedly irritated and inflamed, a self-perpetuating cycle of tear and repair can begin. Chronic inflammation hinders the tendon fibres, causes pain and results in weakness. Due to factors such as their limited blood supply, tendinopathies are easily re-aggravated and can take a significant amount of time to resolve.
Some common causes of a tendinopathy include:
1. Repetitive strain
Muscles and tendons usually strengthen after strain, after all that's what we go to the gym for! However, if load exceeds capacity too frequently, then the tendon fibres don't get enough time to fully repair and the inflammatory cycle continues, leading to tissue damage.
2. Sudden increases in training load
You can usually trace any sport related tendinopathy back to the first time someone increased an aspect of their training regime. This may include (but not limited to) increases in distance, intensity, duration or frequency of your exercise.
3. Postural irritation
Desk posture is a great example of this, rolling forward of the shoulders can decrease the available space for tendons within the shoulder joint complex, leading to congestion of the tendon fibres and an increase in local inflammation and irritation.
What can you do to avoid this?
Always stagger your training! Increase one factor of your training at a time. Factors here may include frequency, intensity, duration or changes in footwear.
Consider any repetitive tasks you may be performing on a daily basis such as at work and look for ways you could decrease or provide breaks from this activity.
Work on your posture, consider purchasing a stand up desk or set alarms for regular breaks from your working position.
How do I rehab a Tendinopathy?
First things first, decrease the activity that caused it in the first place. This can be difficult if it's associated with your job but if it's something as simple as decreasing your running distance than this can be an easy way to promote recovery.
Begin strengthening exercises, the general rule of thumb is to begin with isometric (static) holds. Heel lifts for an Achilles Tendinopathy are a good example here, start in a seated position with a weight on your knee and hold a heel lift for 30 seconds, 5x, 1-2x a day.
Aim for a 2-3 out of 10 level of familiar discomfort and adjust the weight applied accordingly, this is your therapeutic window! Feeling tender after these exercises is normal, but if you are worse for more than 24 hours after the exercise, then the load needs to be decreased.
How long until I'm better?
The textbook answer is 3-6 months... But as stated above, tendinopathies are very prone to re-aggravation, making the prognostic time frame exceptionally variable.
How can an Osteopath help me?
We can help promote blood flow with massage and joint articulation to the area is critical to enabling the tendon to receive all the good things your body can provide. This will also help to remove any stagnant metabolic by products within the area that may be slowing your recovery.
We can help to offload the area by ensuring relevant joints are mobile or strong enough to support your area of injury. Identifying a weaknesses in the hip for example may be the key to decreasing load on a patella (knee) tendinopathy.
We can help fine tune your home exercise program, ensuring gradual progression and decreasing the chance of set backs!
Book online now via www.morgansosteopathy.com.au for tendinopathy based help and advice!
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