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What is a Tendinopathy?

What’s a Tendon?

The connective tissue that attaches our muscles to bone[1].

What is a Tendinopathy?

The failed healing response of a tendon. In most cases of tendinopathy, injury is associated with overuse, resulting pathological processes, which leads to pain, swelling, loss of tissue integrity and impaired performance. Tendinopathy includes other more well known pathologies tendonitis or tendinosis[1,2].


Common tendinopathy locations[1]:

Plantar Fascia (foot)

Achilles (heel)

Patella (knee)

Gluteal (hip)

Rotator cuff (shoulder)

Lateral epicondylalgia (tennis elbow)

Medial epicondylalgia (golfers elbow)


Diagnosis, What to look out for?

Increased pain in the location of the tendon; pain with touching or palpating the affected tendon; pain with loading the effected tendon; and or stretching the tendon; decreased range of motion or muscle length the tendon acts upon. In the beginning or early stages of a tendinopathy an individual may experience these symptoms or discomfort initially loading or performing an activity for the first few minutes which may then resolve; only to return following the activity after cooling down or the next morning [1,3].


Treatment/Prognosis:

Tendinopathy rehabilitation is targeted to improving the capacity of the tendon and muscle to manage load. Your rehabilitation can be spread over 4 stages [3].

  1. Isometric loading

  2. Isotonic loading

  3. Energy-storage loading

  4. Return to Sport

The ability of an individuals to progress through these stages may vary and timeframes to return to sport and or full recovery are ~6-12 months [1,3].

How Our Physio can help?

  • Diagnosis

  • Whole body assessment with biomechanical analysis to identify alignment and movement impairments contributing to your tendinopathy

  • Education and advice

  • Structured hands on and progressive exercise therapy to facilitate recovery

  • Return to sport or activity

Should you have any further questions or regarding tendinopathy or would like to discuss your injury aches or pain with a physiotherapist, please contact Our Physio Central Coast (02) 4339 4475.

References

[1] Millar, N. L., Silbernagel, K. G., Thorborg, K., Kirwan, P. D., Galatz, L. M., Abrams, G. D., ... & Rodeo, S. A. (2021). Tendinopathy. Nature reviews Disease primers, 7(1), 1-21.

[2] Maffulli, N., Longo, U. G., & Denaro, V. (2010). Novel approaches for the management of tendinopathy. JBJS, 92(15), 2604-2613.

[3] Malliaras, P., Cook, J., Purdam, C., & Rio, E. (2015). Patellar tendinopathy: clinical diagnosis, load management, and advice for challenging case presentations. journal of orthopaedic & sports physical therapy, 45(11), 887-898.

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