Tendinopathy Education Sheet
What is tendinopathy?
You may have heard of “tendinitis” which was a commonly diagnosed condition where a tendon became painful and appeared inflamed, thus the “itis” (meaning inflammation). Our understanding of this condition has improved significantly in the last decade and we are now aware that it is not inflammation but is actually a failed healing response creating a disorganisation of collagen fibres in your tendon creating pain and a thickened appearance.
Tendinopathy is very common especially in the Achilles, patella (knee), Gluteal tendons (hip), Rotator cuff (shoulder), Common flexor tendon (Golfers elbow) and Common extensor tendon (Tennis elbow).
Why do I have tendinopathy?
Tendinopathy is caused by increased loading higher than the capacity of the injured tendon or by inadequate rest to allow the tendon the time to recover after loading. Compressive loading (into stretch) or elastic loads (spring type movements such as running and jumping) can be high load to the tendon and may be more relevant.
The biomechanics of the way that you move may also be an important consideration. The injured tendon may not be weak and may instead be taking more than its fair share of workload due to other muscles or joints not moving optimally.
How do I treat tendinopathy?
Another thing that we have learned after thoroughly studying tendinopathy is the treatments that are effective, and others that are probably not as effective as we once thought.
Anti-inflammatories, injections, surgery and passive treatments such as ultrasound might play a part in the treatment of your condition but will generally only offer temporary relief. Stretching (if your injury is where the tendon attaches to the bone) may also be counterproductive.
The most effective and long-term treatment of any tendinopathy is appropriate exercise and load management. By appropriately loading the tendon you can improve blood flow, improve the structure of the tendon and increase its loading capacity. Make sure you follow your physiotherapists instructions strictly as this is often the difference between a good and poor outcome.
How long will it take?
Tendons take quite some time to change structure and so does changing any biomechanical factors that may be contributing to your condition. While everyone responds differently it is common for this condition to last 3-6 months and can even last longer. The longer that you have had the symptoms, often the longer it will take to improve. However, you will often find that if you are very consistent with your rehabilitation program your symptoms will start to improve within the first 2-4 weeks. As you progress the exercises will get harder, but also less frequent.
