Tendinopathy – what is it and how do I treat it?

Have you been recently diagnosed with a tendinopathy? It can be difficult to understand what a tendinopathy is, and how to manage the pain. I have created this simple guide to explain the causes and symptoms of tendinopathy, explore the conventional treatment options, and discuss how osteopathy can play a valuable role in the management and rehabilitation of your tendinopathy.

What is a tendinopathy?

A tendon is what connects muscle to bone. Tendons are attached to every muscle in our body, and they allow your joints to move as your muscles relax and contract. Tendons are normally strong and flexible, however issues can occur. When it does it is known as a tendinopathy. A tendinopathy generally means the breakdown rate of tendon fibres exceeds the healing rate, which alters tendon function.

As you can see the tendon (green) attaches the muscle (red) to the bone.

What are the causes?

  • Overuse or Repetitive Movements: Tendinopathies can occur if overusing or repeating movements in combination with:
    • Not allowing sufficient time for rest and recovery 
    • Poor movement patterns or poor technique
    • Not warming-up or stretching properly 
    • This increases stress on the tendon, making them more susceptible to injury. It not just sports, but other repetitive movements can occur e.g. at the workplace, or with other repetitive daily activities.
  • Aging: As we age, our tendons become thinner and have reduced blood flow. Over time this can cause microscopic injuries to accumulate, leading to gradual weakening of the tendon. 

What are the symptoms? 

The main symptom is pain around the tendon. Initially it can be dull and achey, but can progress to a sharper, more intense sensation with increased activity. Other common symptoms include:

  • Tenderness and swelling around the affected tendon.
  • Stiffness and limited range of motion.
  • Weakness in the affected area.
  • A sensation of crepitus or crackling when moving the tendon.
  • Impaired function around the affected area.

It’s important to note that these symptoms may vary depending on the specific tendon affected and the severity of the tendinopathy.

Commonly affected areas include:

  • Shoulder (rotator cuff)
  • Elbow (tennis and golfer’s elbow)
  • Knee (patellar)
  • Ankle (achilles)
The common wrist extensor tendon can get aggravated when playing tennis, known as ‘Tennis Elbow’.

How osteopathy can help your tendinopathy:

Osteopathy is an holistic approach to healthcare, which means we look at the whole body, not just the pain site. Osteopaths use a combination of manual techniques, exercise prescription, and lifestyle advice to restore balance and promote healing.

When it comes to tendinopathies, osteopathy can offer several benefits:

  • Assessment and Diagnosis: Osteopaths can identify imbalances or dysfunctions contributing to the tendinopathy. Often these imbalances occur in areas that aren’t where the pain in. For example, a tight glutes/buttock can alter the way you walk and run, which can aggravate an achilles tendon. 
  • Manual Therapy: We use a range of hands-on techniques to help your tendinopathy, such as soft tissue massage, joint mobilization, and stretching. This reduces muscle tension, improves circulation, and promote healing and normal function. Osteopaths will treat any area of the body that is indirectly affecting your tendon.
  • Exercise Prescription: Osteopaths can provide a personalised rehabilitation programme for you to improve your overall condition and reduce risk of further injury. This can include a mixture of stretches and strengthening exercises. Graduated eccentric loading exercises are particularly beneficial for the affected tendon.
  • Lifestyle and Prevention Advice: We also look at your daily activities and provide advice on preventive measures to minimize the risk of re-injuring your tendinopathy. This may include recommendations for proper warm-up and stretching routines, activity modification, ergonomic advice and self-care techniques.
Rehab exercises are useful for tendon issues.

Other recommendations:

  • Rest/Modification of Activities: Avoiding or modifying activities that aggravate the pain will reduce stress on the tendon, which can aid the healing process.
  • Medications: Sometimes painkillers or nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to alleviate pain and reduce swelling. However, these should be used under the guidance of your doctor.
  • Shockwave Therapy: This is a non-invasive procedure delivering high-energy sound waves to the affected tendon, promoting healing and pain relief. 

In summary:

A tendinopathy can impact your daily life, but with proper diagnosis and treatment it can be effectively managed. By using osteopathy, which combines manual therapy, exercise prescription, and lifestyle advice, it can help those with a tendinopathy regain their mobility, reduce pain, and restore balance and function. If you would like further advice on how to manage your tendinopathy please give me a call on 07757955097, or book online.

PS: Have you read my last blog on how osteopathy can help jaw pain?

Published 05/09/2023