Tendons connect muscle to bone. A tendon is made of material called collagen. Collagen is a key building block of the body and is considered a connective tissue because it forms tough strands that are like the stands of a nylon rope. Like strands in a rope, the strands of collagen line up. The more strands and the better they line up, the stronger they are. The tendon is wrapped in a thin, slippery covering called the tendon sheath. The tendon sheath allows the tendon to slide easily against the tissues around it.
- Pain often described as a dull ache, particularly when moving the affected area
- Mild swelling
- General weakness
Tendinitis occurs near joints, such as the shoulder, elbow, wrist, knee and ankle. Although many parts of the tendon can be injured. Tendons are designed to withstand high, repetitive loading, however, on occasions, when the load being applied to the tendon is too great for the tendon to withstand, the tendon begins to become stressed. When tendons become stressed, they sustain small micro tears, which encourage inflammatory chemicals and swelling, which can quickly heal if managed properly. However, if the load is continually applied to the tendon, these lesions occurring in the tendon can exceed the rate of repair. The damage will progressively become worse, causing pain and dysfunction. The result is tendinopathy or tendinosis.
Tendinitis is the result of gradual wear and tear to the tendon from overuse or aging. Anyone can have a tendon injury, but people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon.
To diagnose tendinitis, the physiotherapist will ask questions about your past health, your symptoms and exercise regime. Then they will do a physical examination to confirm the diagnosis. Probing and movement may cause pain, but it is important to know exactly where it hurts. The physiotherapist may use a mixture of techniques to relieve pain and boost coordination, strength and flexibility. They may also treat the injury with:
- Activity Modification- is always the first line of treatment and that is altering or changing the activity that is leading to the tendon disorder. This is the most basic form of treatment.
- Modalities- ice, heat, electrical stimulation and ultrasound.
- Taping or splints- can also be used to decrease pain through providing support or decreasing the load on the tendon.
- Manual Therapy-hands on treatment to change the movement of a joint and the surrounding tissue (muscle, ligament, tendon, connective tissue). This includes joint manipulation, joint mobilization, soft tissue mobilization and tool mediated soft tissue mobilization.
- Dry Needling- can reduce muscle tightness around the involved tendons.
- Exercise- is the most important part of treating a tendon disorder to help heal and regain its strength. An exercise plan will be sent to do at home. Along with the work you do at your therapy appointments, they will help you heal faster and safer.
If the symptoms are severe or you do not improve with early treatment, specific diagnostic tests may be requested, such as an ultrasound scan or MRI. Education is also an important part of tendonitis treatment in order to correct body mechanics, form and posture to help reduce the strain on a tendon is under stress from daily or repetitive activities.
If you are in need of physiotherapy in East Gwillimbury or surrounding areas, please contact Ultimate Health Clinic at (905) 251-0162 to let us help you.