Understanding Tendinopathy, Tendinosis, and Tendonitis: Treatments
In our last post, we discussed the related and different causes and symptoms between the stages of tendon injuries “tendinopathy,” “tendinosis,” and “tendonitis”. In today’s post, I hope to discuss these three terms and expand on how a physiotherapist may use different treatment techniques based on the stage at which your tendon injury presents.
- Tendinopathy: The Broad Term for Tendon Problems
As we have discovered, tendinopathy is an umbrella term that includes both tendonitis and tendinosis. Treatment for tendinopathy depends on whether the condition is in the acute (tendonitis) or chronic (tendinosis) stage. Therefore, treatment may involve a combination of strategies based on the condition’s underlying cause.
- Tendonitis: The Acute Inflammation Stage
The main physiotherapy goal of treatment for tendonitis is to reduce inflammation, promote healing, and prevent further damage. Here are some of the more common treatments that I use:
Education on Rest, Activity/Posture Modification:
The importance of resting the affected tendon and avoiding movements that could exacerbate the condition is vital. This may involve modifying activities, temporarily switching to low-impact exercises, or avoiding poor posture/movement patterns that could contribute to the strain of the tendon
The Use of Modalities/Manual Therapy:
Modalities such as Interferential Current (IFC), Transcutaneous Electrical Nerve Stimulation (TENS) or Ultrasound Therapy can be used to reduce pain and inflammation. Soft tissue techniques or joint mobilizations may alleviate muscle tightness, improve joint mobility, and enhance circulation to the affected area.
Stretching and Strengthening:
As inflammation reduces, we will often introduce gentle stretching exercises to restore flexibility to the involved muscles and tendons. Gradual, progressive strengthening or ‘loading’ exercises are generally included to increase the ability of the tendon to withstand further stresses and prevent re-injury.
- Tendinosis: The Chronic Degenerative Stage
Tendinosis is commonly the result of long-term overuse or repetitive stress, and it typically occurs when a tendon is unable to heal properly after repeated injury. The goal of physiotherapy for tendinosis is to promote tissue repair, enhance collagen regeneration, and restore tendon strength. Here are some of the more common treatments that I use:
Strengthening Exercises:
Targeted exercises, specifically eccentric strengthening, are particularly effective for tendinosis. These exercises involve lengthening the tendon under load (e.g., slowly lowering a weight), which helps promote collagen production and improves tendon strength.
Manual Therapy and Myofascial Release:
As with tendinitis, hands-on techniques such as deep tissue massage and myofascial release may be used to break down scar tissue, enhance mobility, and improve circulation to the affected area.
Dry Needling or IMS (Intramuscular Stimulation):
Dry needling/IMS is a technique where acupuncture needles are inserted into trigger points or tight muscle areas to reduce pain and improve tissue mobility. It can be beneficial in releasing tension around the tendon, thus reducing stress on the tendon, and improving healing.
Conclusion:
So far, we have discussed the associated symptoms, causes, and differences between tendinopathy, tendinosis, and tendonitis. We have also touched on some of the relevant treatments that we as physiotherapists may use in helping you to rehabilitate your tendon. In our subsequent posts, we will begin to dive into some of the common tendon conditions we see and treat at Kamloops Physiotherapy & Sports Injury Centre.
If you experience persistent pain in your tendons, consult with one of the physiotherapists at Kamloops Physiotherapy & Sports Injury Centre who can appropriately identify the root cause of your issues and help you begin your journey to recovery.
This blog post was written by physiotherapist Jacob Coelho. To book an appointment with Jacob or one of our other experienced therapists, call 250-314-0788 or book online HERE.