8 Facts about Tendon Pain
Tendinopathy is a broad term to describe painful conditions to the tendon.
1) Tendinopathy does not improve with rest
The pain may reduce with rest, however is often painful again with activity because rest does nothing to increase the tolerance of the tendon to load.
2) Tendinopathy can be caused by many different risk factors
Sudden increase in activities - Particularly those that require the tendon to store load (running, jumping) or those that compress the tendon (lunges, hill running, stretching)
Biomechanical Factors - Poor muscle strength or endurance
Systemic Factors - Age, menopause, elevated cholesterol, increased susceptibility to pain, etc. Predisposed people may develop tendon pain with even subtle changes in their activity
3) Exercise is the number 1 evidence-based treatment for tendinopathy
Tendons need to be loaded progressively so that they can develop greater tolerance to the loads that an individual needs to endure in their day-to-day life. In a vast majority of cases (but not all) tendinopathy will not improve until this tendon load tolerance is reached.
4) Modifying load is important in settling tendon pain
This often involves reducing (in the short-term) tendon load that is causing aggravation.
5) Results on scans/imaging are NOT equal to pain
Tendon pathology is common in people without pain. If you have been told you have ‘severe tendinopathy or even ‘tears’ this DOES NOT necessarily mean you will not get better or have a poorer outcome. Therefore, most treatments are targeted towards improving pain and function.
6) Tendinopathy rarely improves long term with only passive treatment
Passive treatments such as massage, ultrasound, injections, shock-wave therapy etc. Exercise is often the main treatment with passive treatments helping to reduce the load in the short term.
7) Exercise needs to be individualised and progressive
This is based on the individual’s pain, activity level and goal.
8) Tendinopathy often responds very slowly to exercise
You need to have patience and ensure that exercise is done correctly and progressed appropriately. Resist the common temptation to accept ‘short cuts’ like injections and surgery.
Please note that these are general principles and there can be instances where injections and surgery are appropriate in the management of tendinopathy.
If you have any questions about tendons or are suffering with any tendon pain then let us know.
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