For July’s tip of the month we are going to focus on a typical summer injury- that of Tendinopathy. With the longer days and better weather in the summer months, people are generally more active. Many people return to activities that they have not participated in since the previous summer. This sudden increase in activity or training load is often a recipe for injury! One of the most common overuse injuries that we encounter here in the Bon Secours Hospital Physiotherapy Department is tendon injuries.
Each person has thousands of tendons in their body. A tendon joins muscle to bone. Commonly injured tendons include your rotator cuff tendons in your shoulder, your gluteal tendon around your hip, the patellar tendon of the knee and the Achilles tendon which attaches the calf muscle group at the back of your lower leg to your heel bone. This is the largest tendon in the human body.
Tendinopathy is a blanket term to describe all stages of tendon injury. Most tendinopathies occur as a result of repetitive activities and cumulative overuse of the muscle and tendon. For example, an Achilles tendinopathy commonly occurs in runners who have suddenly increased the intensity or duration of their runs. Tendinopathies are also common amongst athletes that repetitively hop or jump in their chosen sport and amongst middle-aged people who play sports, such as tennis or basketball, only on the weekends.
Those with multiple comorbidities or other health issues are more susceptible to tendon injuries. Research has shown that having an increased BMI, Diabetes, high blood pressure and/or high cholesterol can place you at an increased risk of developing tendon problems. There may not be a significant aggravating activity for some of this cohort. The tendon’s natural healing process is often inadequate to cope with the stress being placed on the tendon, leading to tissue damage. This sub classification of tendon injuries is often known as metabolic tendinopathies and will require a more tailored management plan.
A tendinopathy is typically a progressive injury unless managed appropriately. Initially, the tendon may be sore and stiff but these symptoms may ease once the muscle is ‘warmed up.’ Any structural damage to the tendon at this stage is reversible. As the injury progresses, the pain can become more severe and longer lasting. It might even stop the athlete from doing certain activities. There may be restricted movement at the associated joint. There can sometimes be swelling of the tendon. Some tendinous structural damage may be irreversible but the symptoms can improve. If a tendon in this state is not properly managed the injury can progress to the point that the pain, stiffness and swelling are almost constant and quite debilitating. Patients with these injuries may present with a limp or difficulty moving. Tendons in this state can even tear fully. This is known as a tendon rupture.
In August’s ‘Physiotherapy Tip of the Month’ we will discuss management strategies for tendinopathies.
If you think that you could be struggling with a tendon injury, here at the Bon Secours Physiotherapy Department, we would be happy to meet and assess you. All of our Physiotherapists are Chartered and are CORU Registered. We are continually training and upskilling so we can provide expert care for Sports Injuries, Pain Management, Vestibular Rehabilitation, Bone Health & Osteoporosis, Hand Therapy and Orthopaedic Issues.