Tendinitis Treatment Brisbane (tendinopathy)

Written by Roger Morelli, Myotherapist

Brisbane has great weather for sports all year round – so we see loads of tendon irritation here at Knead Massage.  Don’t waste your time and money getting endless treatment – book in for a myotherapy solution and live pain free.

A Tendinopathy is an overuse injury to the structure that connects the muscle to the bone.

A tendon is made up of a substance called collagen.  The collagen in a tendon has very low blood supply compared to the rest of the muscle – which means that any insult suffered by it – can take a long time to heal.

insert image of muscle outlining the tendon

How does a Tendon get injured?

Tendons are fibrous structures that connect muscle to bone.

Tendons are designed to withstand repetitive loading and store energy like a spring – but sometimes they are exposed to load that exceeds their capacity – they sustain small tears which normally heal, however significant over load can exceed the tendons ability to heal before the next instance of overload – and the tendon gradually degenerates and sensitizes until it starts to generate pain as a result of damage.

Tendons are designed to be stretched – too much compression can lead to inflammation.

The majority of tendinopathy’s are close to the joint (where the torsional forces are greater).  These types of tendinopathies are called INSERTIONAL tendinopathies.

Other types of tendinopathies occur in the middle of the tendon (non-insertional)

Common sites of tendinopathy are the hip/leg , elbow, knee, ankle and shoulder.   Tendinopathies appear to happen quickly – but are actually a result of a primary overloading incident (that the muscle is not conditioned to), followed by ongoing use.

Around 2010 the medical fraternity redefined tendon injury to the term Tendinopathy.  Prior to that the type of tendon injury was referred to as Tendonitis (an inflammation of the tendon) or Tendinosis (a degradation of the cellular matrix/collagen of the tendon).

Risk Factors

Age is usually a factor in the onset of tendinopathy.

  • From the age of 30 – the tendons recuperative abilities begin slowing down and most people will have some non-painful tendinopathies. This is a normal part of aging.
  • By the time someone is in their 50’s – they will often have significantly less responsive tendons that heal slowly.
  • Hormonal changes occur – particularly in women during and after menopause which increase the likelihood of tendinopathy – especially shoulder and hip.
  • Research indicates that cumulative micro trauma associated with compressive and tensile forces (such as sport or manual work) increase the likelihood of tendinopathy.
  • Diabetics and people with a few extra kilos are at a higher risk of tendon irritation.

What does a Tendinopathy feel like?

Aggravated Tendinopathy usually causes pain and loss of strength to the affected region.

  • Pain increases with tendon use.
  • Pain and stiffness on arising.
  • The tendon may hurt at night
  • The region may be swollen, red, and hot feeling.
  • The tendon feels “ropey” or “crunchy” when it is loaded

Tendinopathy almost always occurs in conjunction with Bursitis – an inflammatory condition – the area will usually feel hot and painful at times.

How is a Tendon Injury Diagnosed?

Tendonopathy is usually very easy to diagnose.

A Remedial Massage Therapist or Myotherapist will assess you and ask you questions about how the pain started, your exercise habits and working situation.

They will perform special orthopaedic tests that will rule out other conditions and observe your function under load.

If the situation warrants it, they will refer you for an Ultrasound or MRI.  Ultrasound is usually the best tool to establish the quality of the tendon and the Bursa.

How do you treat a Tendinopathy?

  • avoid any activity that increases the pain. 
  • Apply ice or cold packs for 10 minutes at a time – up to twice an hour – for the first three days.
  • Have your biomechanics assessed by a Myotherapist or Remedial Massage Therapist
  • Undertake an Isometric Strength Program for the affected region. Isometric contractions of the muscle have been shown to reduce sensitivity and pain while increasing the capacity of the tendon. 

How long does it take a Tendinopathy to heal?

This will depend on how chronic the tendinopathy has become.  If you have only been experiencing pain for a few days or weeks, it will usually settle quickly.  Long term tendinopathies will take from 12-24 weeks to completely settle.  If someone is diabetic, has a high body mass due to fat, or is older and generally inactive – it is best to assume at least 12 weeks.

 

Common Tendinopathies

  • Achilles Tendon Rupture
  • Achilles Tendonitis / Tendinitis
  • Adductor Tendinopathy
  • Bicep Tendonitis
  • Carpal Tunnel Syndrome
  • Greater Trochantic Syndrome (Gluteal Tendinopathy & bursitis)
  • Golfers Elbow
  • Patella Tendinopathy
  • Peroneal Tendonitis
  • Pes Anserinus Bursitis & Tendinitis
  • Plantar fasciitis (Plantar fasciopathy)
  • Rotator Cuff Tear
  • RSI – Repetitive Strain Injury
  • Shoulder Impingement (Sub Acromial Impingement)
  • Swimmer’s Shoulder
  • Tennis Elbow
  • Tenosynovitis

 

 

Common Tendinopathy Treatments

 

Links

 

 

http://semrc.blogs.latrobe.edu.au/10-things-not-to-do-if-you-have-lower-limb-tendon-pain/

 

http://www.abc.net.au/radionational/programs/healthreport/treating-tendinopathy-neal-millar/6495174

 

http://www.bbc.co.uk/news/mobile/health-11598090

 

https://www.physio-pedia.com/Tendinopathy_Rehabilitation

 

 

References

 

https://jeo-esska.springeropen.com/articles/10.1186/s40634-017-0092-6

 

 

https://pdfs.semanticscholar.org/a80e/daff80617158afed1acbf4d791a7876c7b4c.pdf

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482821/

 

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.832.4735&rep=rep1&type=pdf

 

http://bjsm.bmj.com/content/early/2015/09/25/bjsports-2015-095215

 

http://bjsm.bmj.com/content/49/19/1277?cited-by=yes&legid=bjsports%3B49%2F19%2F1277

 

https://www.semanticscholar.org/paper/MECHANISMS-OF-LOW-LEVEL-LIGHT-THERAPY-Hamblin/a31ed689c69628783abc7d26e82ca4cdcfd78610

http://photobiology.info/Hamblin.html

https://bjsm.bmj.com/content/50/19/1187

 

https://journals.lww.com/cjsportsmed/Abstract/publishahead/Isometric_Exercise_to_Reduce_Pain_in_Patellar.99231.aspx

 

Roger Morelli
Roger Morelli is a Myotherapist at Knead Massage in Brisbane CBD. He loves helping clients improve their quality of life with effective Myotherapy and corrective exercise treatments. He has a special interest in lower limb issues after experiencing a life changing car accident 20 years ago.
Roger Morelli
Roger Morelli

Latest posts by Roger Morelli (see all)

Learn more about Knead Massage

Simply browse our services to find what’s right for you, alternatively pick up the phone and give us a call. We love to help our customers find the best solutions for their health.

Opening Hours

Level 3, 233 Albert Street, Brisbane Qld 4000

T: 07 3003 0801

Mon & Tues 7.30am - 7.30pm
Wed - Fri 7.30am - 9pm
Saturday 10am - 6pm
Sunday 10am - 6pm