10 Facts for Tendons & Tendinopathies

Do you have a tendon injury? A painful hamstring tendon, achilles tendon, or a rotator cuff tendon? Maybe it has been diagnosed as "torn"? These are usually termed a tendinopathy, and have a particular set of characteristics that differentiate it from other soft tissue injuries.

These differences also mean there are specific treatment approaches to settle an acute tendinopathy, or help rehabilitate an old grumbly chronic tendinopathy.

Here are 10 facts about tendon injuries that may surprise you:

Early diagnosis and treatment is key to a successful rehabilitation campaign.
Most tendinopathies do not truly improve with only rest. The pain settles, but recurrence is likely. The total cost of the injury can increase exponentially over time.
There are some inflammatory markers, but it is not really an inflammatory disorder
Exercise is the most effective long-term solution for tendinopathy. It responds slowly, but it lasts longer and develops resistance against future episodes / “flare-ups” for that tendon
Passive treatments are the least effective, along with anti inflammatories. These may be used to help settle the painful tendon initially – particularly if it is a high-grade injury – but it will need to be combined with a rehabilitation program to restore the tendon to its normal tissue behaviour and mechanics.
Tendon pathology (sometimes termed “tears”) are only somewhat reversible, but they do become pain-free with the right therapy and exercise. This is through a process called adaptation, in which new healthy tendon fibres grow around the tendon to allow normal function of the tendon. The unhealthy tissue may not heal or repair – but it does not have to for full pain-free function.
Ice is a very good pain reliever for tendon pain. This has no relation to swelling! Part of this effect is unknown, however we do know cold treatment modulates the pain messages sent from the nerve endings at the tendon to your brain.
Managing a tendon injury successfully depends on understanding the behaviour of that tendon. Reading the tendon’s response to loading (i.e. listening to your tendon), whether it is after rehabilitation or training, will underpin the success and ultimately the prevention of future injuries.
Tendons have no blood supply, and reacts (and somewhat heals and adapts) after injury through a process called diffusion.
The most common reason for recurrence is an incomplete or inappropriate rehabilitation before returning to sport or high-energy activity. The right rehabilitation can work wonders!

If you have a tendon injury, either a recent one or a long-standing one, give us a call.