Tendon pain comes with many titles. You might have been told you have a torn tendon, or been handed a term such as tendinosis, tendinitis, or inclusive of both of these terms, a tendinopathy.
You're probably not really that phased about how we distinguish between these terms but it can be important in the management of your problem. Our understanding of tendon pain has undergone vast improvements in modern years. This is largely thanks to tendinopathy being strongly researched, and we are seeing much better client outcomes as a result.
20 years ago, if you had patella tendon pain, you would have almost certainly been told you had patella tendinitis, that it was an inflamed tendon and you would have been told to rest... and rest... and rest. You might have even been offered a tendonectomy. Years later we learnt that tendon pain is often void of the inflammatory markers typical for inflammatory conditions. Hence the term tendinitis became tendinosis. The differentiation was important because these types of tendinopathy actually respond really well to a strength or loading program.
Initially, eccentric training had the most research behind it. However, there was a certain population who found eccentric load aggravated their pain. These people may have had some inflammation around the tendon or an associated joint problem, for example. Isometric load became the most consistent way to target tendon pain in the early stages.
Research continues to evolve and we now know that, like everything else, it depends on your presentation. Isometrics still do not currently have strong scientific evidence that they give a better outcome than isotonic load. Nobody has your exact tendinopathy. Person A might benefit from lots of manual therapy, Person B might need a short period of rest, Person C might need to improve muscle flexibility, and Person D might purely have to load the tendon. But one thing stands proud; progressive strengthening that fits the individual athlete is still the most scientifically validated approach!
"What about Cortisone?", you ask! Cortisone used the be the quick fix for tendons. We used to advise against it as we wanted you to fix the problem that led to the pain in the first place. We now know that cortisone might actually give a worse long term outcome. When Radial Shockwave Therapy came on the scene, we found a way to reduce your pain without the side effects typically encountered with cortisone. However, we still recommend focusing on fixing the cause of the problem in the first place.
At YouMove Osteopathy, we will look at your situation and utilize the approach that suits your pain profile. We will bring in other modalities or specialist opinions when necessary, and work with you to help you reach your goals. Whether that be to get back on the sports field or to get through a day at work.
Give us a call, or book in online for a targeted treatment plan for your pain. Because nobody moves like YouMove
1. Gravare Silbernagel K, Vicenzino BT, Rathleff MS, et al Isometric exercise for acute pain relief: is it relevant in tendinopathy management?
British Journal of Sports Medicine Published Online First: 10 May 2019. doi: 10.1136/bjsports-2019-100591