It's called a tendon what?
All too often people begin to feel a pain in some of their tendons, particularly when they increase any exercise levels that they have not performed over a long period of time. Tendon pain can be felt in the ankle, knees, hips and elbows, for example. The next thing you know, they have a "tendinitis". No, they don't!
"Itis" means inflammation or swelling. When you have tendon pain, numerous amounts of research has been conducted to demonstrate that there is no inflammatory process that occurs in a tendon. Therefore terms such as "tendinosis" or more commonly, so not to confuse with tendinitis, "tendinopathy" is more frequently used. I have had a keen interest in tendinopathies for many years now, particularly because I have had on more than once occasion, Achilles tendinopathy. Therefore, I can relate to clients when they report with one, just how painful they are! So why do tendinopathies occur? Tendinopathies occur when a person increases their activity levels and the muscles and tendons of that area are not used to the increased compression and load they are being exposed to. To put this into context for the Achilles tendon: Body weight is doubled through your legs when you walk up the stairs. It is TRIPLED when you walk down them! When you run, TWENTY TIMES your body weight is suddenly transferred through your legs. Hence, your tendon becomes irritated and you feel pain. I still have healthy discussions with colleagues regarding the science behind tendinopathies. Some researchers believe there is increased water content in a tendinopathy, some researchers believe the fibres have become mis-matched and muddled with knot like lesions within them. Some researchers believe that the issue is down to scar tissue causing the pain. One thing, they are all clear on; there is NO INFLAMMATION! In addition, we all agree on how a tendinopathy should be treated. Exercise the muscle and tendon group eccentrically. For a muscle to work, it has to shrink or contract. However, when dealing with high impact loads, these muscles also work whilst they lengthen (eccentrically) in order for it to be able to take the tensile load you you wish to put it through. No matter what the tendinopathy, some simple rules follow suit for all: Avoid what we call aggravating factors whilst the tendon irritation settles down, and strengthen the muscle and tendon through eccentric load regularly. There is no quick fix for a tendinopathy. But they do heal and settle down over a period of time. Manual therapy (soft tissue massage and electrotherapy for example) can be beneficial in aiding in settling down the initial symptoms but there is no substitute for strengthening exercise. If you hope to ignore it and hope it will get better on its own, sadly you are only delaying the inevitable. However, just doing "any old strengthening" exercise can do more harm than good. Most if not all tendinopathies have what we call Gold standard exercises to aid in increasing their tensile load. If you do not consider what exactly is going on in the body as a whole, whilst you are trying to reduce a tendinopathy in one area, you may exacerbate one in another area. Therefore, it is not recommended if you accept advice from a lay person who thinks they have the same problem as you, the chances are, they haven't! Always seek to have a full, accurate assessment to ascertain exactly what is going on, in order to have a PROGRESSIVE rehabilitation program constructed for you. So, whatever we are calling tendon pain; tendinopathy, tendinosis, let's be clear: It's not swollen and needs strengthening. Appropriately, regularly and diligently Ignorance is not bliss for these.
