I’ll start off by setting the record straight on the appropriate use of the word “tendinitis”. It is a word used very commonly to describe aches and pains almost anywhere in the body, but more commonly at the elbow, shoulders, ankles, knees, and hips.
The prefix of the word “tendin” indicates we are talking about the tendon. Check, got it. The “itis” suffix at the end actually refers to an inflammatory process happening in the area. During the initial stages of an actual injury to a tendon (first time symptoms are perceived), there may be an inflammatory process at work, but this does not last usually past the first few weeks of initial onset. In my practice when I see clients with tendon issues that have lasted longer than 1 week, I use the word tendinopathy. It refers to a disorder of the tendon, rather than an inflammatory process of the tendon specifically.
Why does this matter? Because we see time and time again that even months after the onset of an injury, people still use anti-inflammatory medication to treat their symptoms, as they continue to do the activity that got them in this mess in the first place. In some cases, medication might help in the short term with the pain but if this is the only line of defense and there is no proper exercise management, the problem is likely to persist.
This brings me to my next point; load management. A tendon is the the connection between muscle and bone. When we move, there is stress placed on our muscles, yes, but also the tendons. Our tendons are made to be, and like to be, loaded and exercised. They do not like to be pushed past their limits of strength, or be compressed, for a long period of time. Something that people find easy to do on their own is stretch the affected area. The reality is, you might actually be compressing the tendon while you stretch, depending on the position. If this is happening, it may feel better at the time, but in the long run the tendon is not building a stronger capacity to handle the demands being placed on it with activity. This is why proper exercise prescription can be the most effective way of treating tendinopathy.
I get asked frequently: “So does that mean I can’t do the things I like to do for a couple months?” No, BUT… (there’s always a but)… it’s important to understand that tendons need time to recover after activity. My best advice to people who are still required to do the activity that provokes their pain is to take short, frequent breaks. Allowing the tendon to recover helps to prolong its capacity for doing a certain activity. In most cases, complete rest is not the answer to the problem. There needs to be optimal loading of the tendon to properly recover; not too little, not too much.
In the case of tendinopathy, doing the right things are just as important as not doing the wrong things. Sometimes it can be fairly easy to avoid the things that clearly make the symptoms worse, but knowing what exercises to do can seem like a daunting task for anyone. This is where a physiotherapist can help. We are specialized in exercise prescription and can help guide recovery. If any of the above sounds like you, book an appointment with a physio today and #GetPTFirst.
Jordan Gillis, PT