Tendinopathies

What is a Tendinopathy

Tendinopathy is a failed healing response of the tendon often resulting in pain or functional changes associated with overuse in and around the tendon. See throughout this blog 3 tips to assist with managing a tendinopathy.

3 phases of Tendinopathy

Reactive

Often the first stage of a tendinopathy, the result of compressive or tensile overload. This is often due to sudden increase in physical activity, a change in activity levels or a burst of new activity.

Disrepair

Degenerative

Contributing factors to tendinopathies or tendon injuries Tendinopathies, whilst really frustrating, are very common and something we see regularly as allied health practitioners in a movement based clinical setting. There can be numerous factors that can contribute to the development or presence of a tendinopathy or tendon related injury, these include:

• Environmental

• Physiological

• Biomechanical

Common areas of tendinopathies:

Any tendon with the wrong environment or with pre-existing factors can develop issues and the common sites we see in clinic are:

• Proximal Hamstring

• Achilles

• Patella

• Long head of biceps

• Rotator cuff muscles (subscapularis, infraspinatus, teres minor, & supraspinatus)

• Wrist extensor bundle (lateral epicondylitis/tennis elbow)

Tip 1. Isometric exercises

Promotes tendon stiffness which is key in optimising tendon function.

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Do’s and don’s when you have an injured or irritated tendon:

We do know that tendons when irritable hate a few common things!

There are three main things we look to avoid:

Compression

Tendons as a general rule hate both direct (e.g. hamstring tendon compressed against the sit bone when sitting down) and indirect compression (e.g. stretching of tendon).

Excessive Stretching

Cold

Despite good intentions, a lot of the time tendinopathies come from going too hard too soon. When this occurs, often our first thought is to completely stop and rest. However, majority of the time this actually has the opposite effect and can in some cases exacerbate our symptoms.

Tip 2. Avoid Overstretching

Tendons prefer to be contracted over stretched especially at end ranges.

Intrinsic factors include:

• Biomechanical abnormalities

• Insufficient preparation, resulting in a mismatch of blood flow supply and nervous system stimulation to meet the demands physiological stress

• Chronic conditions: Diabetes hypertension, obesity, gout, hyperostotic conditions

Extrinsic factors include:

Excessive mechanical overload and training errors such as:

• Increased interval training

• Abrupt changes in scheduling

• Major rapid changes to training surfaces resulting in additional unplanned stress - etc excessive hill training, training on hard or sloping surfaces, increased mileage, increased repetitive loading, poor shock absorption

Tip 3. Heat and Warmth

This can consist of both applying heat to ease symptoms. As well as ensuring tendons are adequately warmed up prior to activity.

Management of Tendinopathies:

Whilst tendinopathies are quite common, the nature of their gradual onset can mean that we often may ignore it or downplay our symptoms. Tendons respond really well to physical therapy and don't have to be something you just put up with. With appropriate management, it can allow you to get back to doing things you enjoy. If you think you might be experiencing this, booking in with one of our Exercise Physiologists or Osteopaths for a individualised assessment and management plan.

Team Motus x

Written by:

Abbey Watts (Exercise Physiologist)

Sarah Alexander (Osteopath)