Working Toward a Better Understanding of Tendinopathy
In nearly every sport, overuse injuries are so common there are names for them like “tennis elbow,” “jumper’s knee” or “runner’s knee.” And these injuries aren’t just limited to sports. Military personnel, for example, commonly experience Achilles (ankle) and patellar (knee) injuries. The reality is that anyone whose work causes them to perform repetitive movements – assembly line workers, even office workers – may experience problems in large tendons.
In some situations, it may not be possible to take an extended break from an activity, while for others it may be tempting to ignore the discomfort in hopes it is only temporary. The reality, however, is that left untreated, more severe or chronic problems could arise. But determining the best course of treatment can sometimes be confusing – a lack of standard assessments, a misunderstanding of the root cause of the pain, and even the extent of damage can make it difficult to know what treatment is most appropriate.
One common cause of pain is tendinopathy – essentially the collagen (or protein) in the tendon starts to break down. This is sometimes confused with tendinitis, which happens when the tendon becomes inflamed – usually when there is too much force, or the force is too sudden for the tendon to absorb and it becomes damaged. The reason it is important to recognize the underlying cause is that the treatments and timelines will be different.
In the cases of tendinitis, the goal is to reduce the inflammation – rest and anti-inflammatory medicines like Ibuprofen may be used, and recovery can be several days to several weeks depending on the severity. With tendinopathy, if the treatment is only rest and avoiding activity - it may not result in changes to the tendon that allow for a pain-free return to sport or work for the long term. The goal is to break the cycle of overload on the tendon and help it regain its structural and functional strength. For athletes, this may mean analyzing and optimizing their movement whether it is running, cycling or any repetitive movement. Other physical therapy treatments such as eccentric strengthening (or exercises that cause the muscle to lengthen as it contracts), improving joint mobility and movement control exercises may also be used.
UW Health physical therapist Marc Sherry explains that one concern in cases of tendinopathy is accurately identifying the stage of tendinopathy that a patient may be in, “Acute reactive tendinopathy may benefit from different treatments than those with chronic degenerative tendinopathy.” Acute reactive tendinopathy usually occurs when there is a rapid increase in load - or pressure - on the tendon, like when a runner starts doing hills or having fewer rest days. Degenerative, on the other hand, is usually seen in older athletes where there has been a history of chronic pressure - or overload - on the tendons. As an example, professional basketball players can experience Achilles ruptures – such as DeMarcus Cousins did earlier this year. Often, the ruptures are the result of chronic degenerative tendinopathy.
Tendinopathy Study - Research Participants Needed
Sherry explains that to help develop standard guidelines for assessing tendinopathy, UW Health Sports Medicine and Rehabilitation is participating in a research study funded by the U.S. Department of Defense, and including research partners the University of Miami and Kiio, Inc., a software and technology developer in Madison, Wis. Participants for the study are needed, including individuals who have no history of tendionapthy and those who have a medical diagnosis of chronic Achilles or patellar tendinopathy. For more information, email firstname.lastname@example.org or call (608) 265-3018.
Date Published: 03/12/2018