Tendon pain: everything you need to know 

Have you been told that you have tendonitis or tendinopathy? Has it been frustrating, painful, or not going away?
In this article I will be covering:
What is tendinopathy?
What causes tendinopathy?
Will tendinopathy ever get better?
What is the BEST way to treat tendinopathy?


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Several common ones include:

What is tendinopathy or tendinitis?
For background, tendons are a connective tissue that connects muscles and bone. They function to absorb and transfer forces during movements such as running, walking, or lifting.
What’s amazing is that tendons have the unique ability to adapt and change in response to mechanical loading. This could be anything from a runner that ups their mileage in training for a race to a blue collar worker at a factory who’s had to be pulling extra shifts.(3)

Sometimes if these changes happened too quickly the tendon can become “overwhelmed” leading to pain and irritation. This manifests itself in pain with movement and activity that is often nagging and persistent.(4)

What causes tendinopathy ?
“Tendinopathy” is a general term for changes in the tendon associated with pain, reduced tolerance to loading and activity, change in the tissue structure. Tendinopathy occurs when the tendon fails to adapt or fully heal from a new load (or activity) and into a new capacity ( ability to respond). Common symptoms include dull muscle pain, stiffness in the morning, and pinpoint pain with movement.

Does tendinopathy ever go away?
If you’re reading this you’ve probably wondered how long it will take to go away. While your unique situation will vary, tendon pain takes time and patience. In general, tendon pain is something that takes “weeks to months” instead of “days to weeks” to fully heal. On average, with proper treatment (more on that below), tendinopathy can take several months for full improvement.(5,6)

How do I treat tendon pain?
Before we talk about what is the BEST way to treat tendinopathy let’s examine what is not helpful. Rest, long term steroid injections, and prolonged NSAID use (ibuprofen) have little scientific support in treating tendinopathy.(7)

The research has shown that progressive exercise and rehabilitation is the best way to treat tendon pain. Your health care provider should take into account your activities, load, and intensity level to build a rehab program for you! Gradually, this rehabilitation will build the strength and capacity of the tendon in order to get you back to what you want to do or need to do in your life. Additionally they should be able to vary it depending on your level of symptoms and have a clear plan on how to return to activity or your sport.

Other treatments such as soft tissue therapy, dry needling, or joint manipulation can be useful for short term pain control. While helpful, they are meant to be an adjunct to care, the emphasis will be on progressive loading at home.(8)

Do I need surgery?
One other major concern I hear often is “do I need surgery?”, and for the vast majority of patients the answer is a firm NO. In fact, surgery for tendon pain has been shown to be no better than active care and is only to be considered after 12 months of exercise focused treatment.(9)

What’s the bottom line?
Tendonopathy is tendon pain due to overload or overuse.
Surgery and rest are not recommended treatment.
Tendon pain requires patience and proper rehab to fully recover.

If you have any questions about your specific tendon pain or in getting treatment that is right for you, contact us at 513-531-2277 or schedule here:  https://www.norwoodchiropractic.com/pages/book-an-appointment

Dr. Richard Yost is the Clinic Director at Norwood Chiropractic & Sports Injury Center. He has been fortunate to work with USA Track & Field along with a number of ameurature and professional athletes. Dr. Yost is one of a few providers in the Cincinatti area certified in Active Release Technique (ART), the gold standard in soft tissue injury treatment.

Dr. Richard  Yost

Dr. Richard Yost

DC, ART Provider

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