In this weeks blog Matt Ho APAM takes you through the most common Do's and Don'ts when thinking about your own tendinopathy.
Tendinopathy: The Do’s and Don’ts
‘Tendinopathy’ is an umbrella term used to describe any pathology of the tendons. You may have heard it referred to by many different names: tendinitis, tendinosis or tenosynovitis. Some common tendinopathies include achilles, patella, common wrist extensor and biceps. Whichever type, and whatever the location, tendinopathy can manifest as significant pain and cause a reduction in function. Here are some basic Do’s and Don’ts to ensure you can overcome your tendinopathy as quickly as possible!
See a healthcare professional, such as a sports physician or physio. They will diagnose the issue, and give you to correct treatment and management plan
Manage your physical workload. Most tendinopathies are caused by a sudden change in activities (usually an increase). This pertains particularly to activities that load or compress the tendon (e.g. walking/running for Achilles tendinopathy)
Reduce load initially. This will help reduce pain, and allow you to gradually load as time goes on to return to normal activity levels.
Use anti-inflammatories and ice to help manage the pain short term. There is no evidence to suggest that this aids with tendon healing, but this should help comfort levels initially.
Use passive treatments initially for pain modulation. Note that these passive treatments (such as ultrasound, shockwave, injections) rarely help long term, and should only be an adjunct to exercise therapy. Multiple injections should be particularly avoided as these provide poorer outcomes according to current research.
Use an individualised, progressive loading regime.
Have patience! Tendinopathies are very slow to progress, even with appropriate exercises. Ensure that the exercises are correct, and that you are adequately progressing the load to attain the best outcome.
Rely on passive modalities as the sole treatment for your issues long term.
Stress about imaging findings. We know that imaging findings and tissue damage does not correlate well with pain and function. The management program should be based on returning you to your former function, and not on tissue healing specifically.
Continue to train normally. This may only serve to prolong recovery. Look to reduce load initially, then gradually increase.
Rest completely. Whilst an initial reduction in loads is recommended, this does not mean complete rest! It is important to maintain function wherever possible
Get frustrated that you aren’t 100% better within a month. Tendon healing takes time, so make sure you are adequately progressing your loading exercises!
Forget about biomechanical factors. Your physio/podiatrist/sports physician should be able to help you address any biomechanical risk factors that you possess, and ensure that the issue does not resurface in the future