Jumpers knee/Patella tendinopathy
Tendinopathies are injuries to a tendon as a result of gradual wear and tear from overuse. Sometimes they may appear to happen suddenly, but are usually a result of repetitive tendon ‘overloading’. They typically cause pain, stiffness and a loss of strength in the affected area.
Increased pain when you use the tendon
Pain and stiffness when you get up in the morning
A tendon that feels fine when it’s warmed up (during exercise) but becomes painful once cooled down.
Tendinopathies can be quite frustrating, painful and stubborn injuries. Identifying the symptoms and seeking Physiotherapy treatment early will increase your likelihood of a speedy recovery. The longer you leave it, the more likely the tendon is to become degenerative and difficult to manage.
Due to ongoing research, the way Physiotherapists manage tendinopathies is constantly changing. Here’s a few tips on how we approach tendinopathy management at Elite Physiotherapy.
1. Rest is not necessarily best!
Use it or lose it does apply to tendons. Resting reduces the tendons ability to take load along with the health of the muscle attached to the tendon. On the other hand, you cannot ignore the pain. Try reducing loads to the level that the tendon can tolerate and then slowly increase the tolerance of the tendon to load under the guidance of a Physiotherapist.
2. Be proactive, not reactive.
Physiotherapy can definitely assist with pain relief and off-loading the surrounding musculature. However, research clearly shows that applying specific loading to a tendon is most beneficial in regaining normal, pain free function.
3. Injection therapies aren’t the solution.
Injecting substances into a tendon has not been shown to be effective in good clinical trials. Try to avoid having an injection into a tendon unless the tendon has not responded to a good exercise based program from your Physiotherapist.
4. Respect pain
Pain is a way of telling you that there is a problem and that the load is too much. Reduce the aspects of training that are irritating/overloading your tendon. There are numerous physiotherapy techniques that can be implemented to help reduce ‘tendinopathic’ pain (taping, soft tissue release, dry needling).
5. To stretch or not to stretch??
Adding stretching to most tendons can add detrimental compressive loads to the tendon. If your muscles are tight use massage to loosen them.
Elite Physiotherapy stocks a wide range of self-massage tools including spikey balls, foam rollers and massage stick rollers. We also have an experienced Remedial Massage Therapist (Bec) who can help you off-load those muscles/tendons.
6. What about massaging a tendon?
A tendon that is painful is already irritated. Therefore, adding further insult by massaging it may actually increase your pain. Sometimes tendons will feel better immediately after a massage but can then be worse when you load them. However, dry needling the tendon may be an alternative (ask your Physiotherapist).
7. Don’t be concerned about the scans of your tendon.
Imaging of your tendon with ultrasound or MRI can frighten you, and the words used by doctors such as degeneration and tears can make you wonder if your tendon should be loaded. There is good evidence that the pathological tendon can tolerate loads, especially when you gradually increase the loads on them. Speak to your Physiotherapist about a safe loading program.
8. Do not Take short cuts with rehabilitation
Taking short cuts with rehabilitation does not work. You need to give the time that the tendon needs to build its strength and capacity. Rehabilitation can take 3-6 months or occasionally more, but the long term outcomes are good if you do the correct rehabilitation.
For expert diagnosis and management of your tendinopathy, give us a call 89418555 to speak to one of our experienced Physiotherapists. We will help improve your pain and function through a variety of hands on treatments as well as with the establishment and guidance of an individualised rehabilitation program.
(Adapted from Jill Cook).
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