One of the most common types of injury we treat is painful tendon injury; professionally referred to as tendinopathy. Tendinopathies are characterised by pain most commonly at the tendon attachment to bone, caused by the tendon being overloaded by activity.
Tendinopathy can present itself in any of the load-bearing tendons, but occurs most often in the Achilles, Patella, Hamstring, Gluteal, Adductor, Rotator cuff and Lateral elbow tendons.
We will take a quick look at how these tendons become painful and give you some tips on how to help rehabilitate them, to decrease pain and improve function.
What Is Tendinopathy?
Tendinopathy is a term used to describe persistent tendon pain and loss of function related to excessive load to that tendon.
Tendinopathy is a classic example of what we in the business call an overuse injury, as it usually manifests when someone overuses a tendon during physical activity. Overuse tendon pain does not necessarily need to be sport-related; often household chores, gardening, or other everyday activity can put excessive load on your tendons to cause pain and loss of function.
You might know someone who has suffered from a tendinopathy but refer to their condition as something else. Some common names used to refer to certain tendinopathies include:
- Jumper’s knee
- Tennis elbow
- Golfer’s elbow
- Swimmers shoulder
- Shoulder impingement
How To Identify Pain Caused By Tendinopathy
Tendon pain is mostly localised (not widespread) and can be brought on by activities that load the tendon – the greater the load the greater the pain response. Pain is often aggravated when the tendon is palpated (pressed on), stretched or used in an explosive manner.
A common feature of tendinopathy is the “Warm-up effect". When you start your activity the pain is present, but it begins to ease as you continue, then the pain might return later on during your activity. Pain might also be worse than normal the next day.
More pain and stiffness can occur when the tendon in question is not used for a while, such as after waking up from a nights sleep. For example, those suffering from Achilles tendinopathy will report that their first steps out of bed are the most stiff and painful, then eases up the more they walk around.
Tendinopathies often don’t show all of the above characteristics which can make it challenging to identify. To add to the challenge, other conditions might show similar features. A knowledgeable Biokineticist can assist in differentiating between these conditions or will refer you to the relevant healthcare professional for further investigation.
The Different Types of Tendinopathy
The most common tendinopathies include:
- Achilles Tendinopathy – pain at the achilles tendon directly above the heel, mostly aggravated with running.
- Patella tendinopathy – pain at the patella tendon directly below the knee cap, mostly aggravated with jumping.
- Proximal hamstring tendinopathy – pain at the hamstring tendon at its attachment to the pelvis (back of the thigh just underneath the buttock and inwards towards the groin area), mostly aggravated with running.
- Gluteal tendinopathy – pain at the gluteal tendon directly above the hip bone on the outside of your hip, mostly aggravated by lying on your side, standing, walking or climbing up and downstairs.
- Adductor tendinopathy – pain at the adductor tendon in the groin area, mostly aggravated with fast running and changing direction.
- Lateral elbow tendinopathy – pain at the tendons on the outside of your elbow joint, mostly aggravated with gripping and extending your wrist.
- Rotator cuff tendinopathy – pain broadly over the deltoid and upper arm region, mostly aggravated by lifting your arm, especially with resistance.
Top 5 Tips For Treating Painful Tendons
1. Load management
Managing the load requires reducing the load of activities that aggravate your tendon. Once the tendon settles down, it will allow you to perform resistance exercises to increase the tendons capacity to handle more load.
2. Avoid complete rest
Stopping activity altogether will decondition your tendon and even though your pain might decrease now, when you start the activity again, the pain often comes right back.
3. Avoid prolonged stretching
Stretching compresses the tendon against the bone it’s attached to. Although this is a normal occurrence, prolonged stretching can aggravate an already sensitive tendon.
4. Avoid explosive loads
Movements that require the tendon to quickly stretch and then produce force rapidly can aggravate the tendon early in the rehab process.
5. Load the tendon with resistance exercise
Perform resistance exercises that load the tendon in ways that do not aggravate it excessively. Progress towards more aggravating loads gradually, as tolerated.
Need Help With Healing Your Tendinopathy?
Recovery from overuse injuries like tendinopathy requires patience and a well thought out rehabilitation plan. The good news is, we have the expertise to help you identify and treat your painful tendon injury effectively. Read more about our injury rehabilitation process here or if you feel you need some extra guidance or would like to kick start your rehabilitation journey, chat with one of our friendly consultants here.
Disclaimer: This content is not medical advice and is intended for general education purposes only. It should not be used to self-diagnose or self-treat any medical condition. Do not use this information to avoid going to your own healthcare professional or to replace the advice they give you. Dhansay and Roberts Biokineticists makes no representations about the accuracy or suitability of this content.