There are a few main tendons that can be problematic namely the Plantar Fascia (Arch of foot), Achilles (Heel) , Patellar (Knee), Gluteal (Hip) and Rotator Cuff at the Shoulder.
Each of these can presents in their own unique way.
- Pain is the main reason people seek advice but there often other tell tale signs typical of a cranky tendon.
- Some of our clients report severe pain and reduced ability to work the body part in question.
- Others recall stiffness after rest or first thing in the morning that takes 2 to 10 minutes to loosen out.
- They can be hot and tender to the touch (Patellar & Achilles). They can have significant knock on effects to other body parts if allowed to continue for too long.
- Night pain is a disrupting and worrying one. This can impact one’s general energy and mood levels and should not be allowed to continue for too long due to the multitude of knock on effects.
Tendon pain problems typically (and this is a generalisation) follow a specific profile and are often directly related to any combination of age, gender, activity, prolonged medicine use and training overload.
They are difficult to rehabilitate with people often reporting that even after prolonged rest the pain returns. There are several reasons for this.
As previously mentioned. Tendons can be cranky, and stubborn. Why is this? Well kinda like some of us human beings 😉 it has to do with their makeup.
Their unique anatomical structure and slow rate of growth affects their ability to generate new tendon tissue and thus equates into lots of rehab effort for very small amounts of progress. This as we say to our clients is the norm and is expected.
Tendons can and do recover but you will learn so much on that journey and they will (force) you to respect them and their set ways .
By that I mean that despite multiple attempts to rush your rehab the tendon will flare up, get painful and even set you back. Once you respect it and stick with your graduated rehab programme both you and your tendon will achieve the best results.
Essentially successful tendon rehab is all about getting the tissue and body part(s) in question working correctly so that the whole system can function without pain.
What about surgery? Can you fix it that way?
In a nutshell the only time surgery is indicated for tendon is when they become detected from the bone which they connect.
More often than not this type of injury occurs as a result of trauma from a big fall or heavy collision where the force of the impact causes the tendon to detach from its bony attachment called the enthesis or where the muscle and tendon join called the musculotendinous junction (MTJ) .
Surgery will reattach the tissues and physiotherapy and rehabilitation will guide your recovery.
What about shockwave therapy?
Shockwave is a newer treatment out there proclaiming to have great impacts on recovery.
In essence shockwave can be useful to get a cranky painful tendon to settle to a point where exercise and load can be put through the tendon once again.
What about injections or pain medication?
Again the jury is out on the golden bullet for tendon pain. Ibuprofen can be effective in the case of an acute tendon flare but is not so for an ongoing recurrent grumble and stiff tendon. You’ll know exactly what I am talking about if you have or had either or both of these issues.
So how long can it take for a tendon to get right?
Allow me to break this answer into 2 parts.
Acute tendon pain
This is one that flares up due to a spike in activity or exercise that results in an overload to that particular tendon.
Eg. take a runner who usually runs three 5 ks per week but then got a notion to do a 10 k one weekend because they were feeling so good and the weather was beautiful.
They felt good afterwards and then ran again as normal on Monday doing the usual 5 k loop.
In terms of load their Saturday run is doubling the load of what the knee can tolerate and will take 3-5 days to present itself.
Why? Well I did mention it already above. Because tendons are slow to react to stresses and strains.
These flare ups can take up to weeks to fully settle and get on top of.
Persistent tendon niggle/pain
This one is more of a slow burner. Take someone who used to go to the gym in previous years but is reaching middle age and still continuing to do hill walking but the side of their hip tends to niggle after each walk.
This can be a low level of pain and disappear after a couple of days. However, it can gradually get worse over weeks/months.
The longer these are allowed to go on can effect the recovery time – they usually take months to alleviate.
What about me? I don’t even partake in sport and my GP and MRI say that my rotator cuff tendon is half worn away. This has to be a problem right?
The answer to this is not all bad. Tendons can fray and some parts can detach or look ‘degenerated’ on MRI. This is normal.
It is part of the aging process. However, as you get older, your body will naturally lose muscle mass & strength, unless you prevent this from happening through strengthening exercises. This strengthening will make your muscles stronger and prevent the tendon overload.
The bottom line is that there is no need to be living with Tendon Pain. We have a process that involves education/advice, treatment and a customised exercise rehabilitation program that will get you back to where you want to be
If you have any other queries or you are not quite sure where to begin, feel free to contact us via email, or over the phone on 025 35015.
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Thank you for reading, and remember:
Move Well, Feel Well, Be Well