FOCUS ON HEALTH

What is tendonitis?

By Virginia Nsitem

Do you feel pain near a joint or bone that is worse with movement? Do you feel swelling near a bone or joint? Or a crackling sensation near the joint? These are common symptoms of tendon injuries.

What are Tendons?

Tendons are fibrous tissues that are located at the end of muscles. They are made of collagen. The tendons attach muscles to bones, and help transfer the load from the muscle to the bone. For example, The Achilles’ tendon attaches the calf muscle to the heel. Tendons are found throughout the body, and common areas for tendon injury include the shoulders, elbows, wrists, hips, knees, and feet.

Injury to Tendons:

Tendon injury often occurs from overuse of the tissue. This can happen with repetitive activity or overloading the tissue. In addition, as we age, the tendon tissue becomes weaker, and more susceptible to damage. Studies show that middle-aged adults are more likely to suffer from a tendon injury.

Common symptoms:

• Elbow tendonitis – This injury can occur at the inside of the elbow (medial epicondylitis, also known as golfer’s elbow) or the outside of the elbow (lateral epicondylitis, also known as tennis elbow). Pain with turning, holding, and grasping activities. Pain with manual labour tasks such as painting and carpentry work.
• Shoulder tendonitis – Pain with overhead tasks, lifting, reaching, pushing, and pulling activities. This injury can affect one or more of the rotator cuff muscles, or other muscles that attach to the shoulder.
• Patellar tendonitis – Pain at the bottom of the knee cap (also call jumper’s knee). Pain with jumping, rising from a seated position, and climbing stairs.
• Achilles’ tendonitis – Pain at the heel that is worse with running.

TENDONITIS is an acute injury that occurs when the tendons are overstretched and develop tears, which causes inflammation. This causes swelling and pain at the site of the injury.

If the tendon injury fails to heal and becomes chronic, we often label that injury as TENDINOSIS. Tendinosis (also spelled tendonosis) is a chronic injury, and instead of inflammation of the tendon, there is damage, degeneration, and deterioration of the collagen that makes up the tendon.

Treatments for Tendon Injuries

Before treatment and rehabilitation can begin, it is important to get an accurate diagnosis. Tendonitis is an acute injury that typically heals in 4-6 weeks. Tendinosis is a chronic injury that may take up 3-6 months to fully heal (collagen may take at least 3 months to rebuild). Tendon injuries are diagnosed based on your symptoms, the examination, and findings on x-rays, ultrasound studies, CT scans, or MRI studies. Chiropractors specialize in diagnosing, treating, and rehabilitating injuries of the muscles, ligaments, tendons, joints and nerves.  A correct diagnosis is important to rule out more serious conditions that may be causing your pain and symptoms.

For the treatment of Tendonitis, your chiropractor may advise you to follow the PRICE protocol which is Protection (protect the joint from further injury using special braces or splints), Rest (rest the injured muscles, ligaments, and joints), Ice (apply ice compresses to reduce the pain and inflammation), Compression (use bandages or special joint wraps to provide support to the joint), and Elevation (elevate the affected region to decrease swelling).

For the treatment of Tendinosis, your chiropractor may advise you to rest (especially when doing a repetitive task) in order to prevent further damage to the collagen, to support the injured area with bracing, and to follow proper ergonomics and posture techniques.

Chiropractors may also include:

• Therapeutic Laser therapy to reduce inflammation and pain, and promote healing of the collagen.
• Physical therapies to improve tightness of the muscles and ligaments, and restore proper movement to the joints.
• Exercises: Stretching exercises, strengthening training exercises, and education on proper warm-up exercises are important to healing tendon injuries and preventing them from recurring.
• Massage therapy and Acupuncture are helpful for providing a pain-relieving effect throughout the body, an anti-inflammatory effect, and a general sense of improved well-being. Deep tissue massage and cross-friction massage may also help with healing of tendinosis injuries.
• Education on the progression of the disease and the importance of balancing rest and exercise to slow down the deterioration of the joints.
• Your chiropractor can also inform you on proper equipment and foot wear to cushion joints, and supplements that may promote the growth of collagen.

Stop the Pain…Before the Pain Stops You!

(Dr. Virginia Nsitem is a chiropractor specializing in laser therapy for muscle, joint, and nerve injuries, and is a Fellow of the Royal College of Chiropractic Sports Sciences in Canada. She may be reached at (905) 275-4993, or by email at totalhealth@bellnet.ca)