Our physiotherapist Vernon Mittal discusses what to do when you have a tendon injury (tendonitis or tendinopathy) and highlights the treatment you can seek from our physiotherapists.
What is a tendon injury?
Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. Tendinopathy (previously referred to as tendonitis) is characterised as an overuse tendon injury. It results in pain and a decreased tolerance of the tendon to withstand load, therefore the overall function is reduced. Changes in tendon structure at a microscopic level can result in the affected tendon to be less capable of sustaining repeated activity.
What causes a tendon injury?
There are a number of extrinsic reasons (factors that can be controlled) as to why it may have occurred but typically it is the following:
– Sudden acute increase in training/exercise load
– Commencement of training/exercise if previously sedentary
– Direct trauma to the tendon
– Returning to the same level of training/exercise post a period of injury/rest
Intrinsic reasons (factors that cannot be controlled) also play a part in the onset/risk of developing tendinopathy. They include:
– Body biomechanics
Where do tendon injuries occur?
The most common place for a tendinopathy is at the Achilles tendon. However, other common places include the shoulder (rotator cuff tendinitis), elbow (tennis elbow), hip and knee.
Treatment for tendon injury
Load. This is the key to managing tendinopathy injuries. Load is a term for the amount of activity/exercise that the affected tendon is exposed to. Even though it may be uncomfortable, we still want to keep the strength in the affected tendon at optimal levels throughout the entire process, even from day one.
Your physiotherapist will work alongside you to manage the tendon load and ensure a smooth progression of exercises and activity. We don’t want too much load too quickly, or not enough load either.
It will be critical to monitor the pain/stiffness levels in the tendon throughout the exercises, immediately after and the next morning. These will be important indicators for the physiotherapist to assess whether we increase or decrease exercises.
Exercises for tendon injury
Initially for pain relief, an isometric exercise will be given. This is where you do the specific exercise and hold the position for a number of seconds. This allows the muscle to maintain its strength as well as giving the brain some feedback that it is ‘ok’ to use our muscles.
Once pain levels have reduced to an appropriate level, an isotonic exercise will be given. This means the muscle is being used over a shortening and lengthening phase; i.e. calf raise. This type of exercise is the most functional to everyday life.
Your physiotherapist will progress your exercises as they deem appropriate.
How long does it take for a tendon injury to heal?
The timeframe of full recovery is dependent on a few things including:
– The level of pain
– The length of time between the initial pain and seeking professional help
– The type of activity/sport that you would like to return to
Therefore it can be difficult to state a specific timeframe. Typically, for minimal pain it may range from 3-4 months recovery. For severe pain/long withstanding pain, it may range from 6 – 12 months.