Overuse Injuries - Tendinitis & Tendinosis
Injuries aren't always caused by trauma (ex. falling and breaking your ankle or separating your shoulder). Rather, the majority of injuries people seek Physical Therapy for are associated with overuse.
A large majority of overuse injures are those involving the tendon.
Tendons - a quick and dirty anatomy lesson:
- Tendons attach muscle to bone and concentrate a pulling force in a limited area.
- The tendon contains wavy, parallel, collagenous fibers surrounded by a gelatinous material that decreases friction.
- When a muscle contracts these fibers are straightened in the direction of the load. When relaxed, the fibers returns to their original shape
When a muscle contracts repeatedly or in an abnormal fashion, the tendon can become irritated and inflamed. Typically, this results in pain with movement, swelling, possibly some warmth, and a crackling sound caused by the tendency of the tendon to stick to the surrounding structure as it slides back and forth.
**The key to treatment of tendinitis is rest and controlling the inflammation through icing and other anti-inflammatory techniques.
If repetitive overuse continues and the irritated tendon fails to heal, the tendon begins to become stiff and weak or degenerates. This is what we refer to as tendinosis. This is the category most chronic tendon problems fall into. The tendon is still usually painful when moved. The outer covering (sheath of a tendon may be visibly swollen and sometimes a tender lump appears. The area will generally feel stiff and have less motion.
**The key to treatment of a tendinosis is causing healthy remodeling of the tissue which can include dry needling, soft tissue mobilization techniques, and most importantly eccentric exercise and correcting any poor movement patterns contributing to the disorder.
In many cases, tendonitis can be avoided by taking a few simple precautions. Some helpful strategies include:
- Always warm up prior to any moderate-vigorous physical activity
- If adding a new activity or increasing the intensity of an activity do it gradually (increase of no more than 10% per week)
- Avoid activities that require repetitive or prolonged periods especially reaching over your head
- If you are active in organized sports or exercise regularly, pay attention to your technique. Ask your coach or trainer for guidance. Poor technique can often lead to overuse injuries.
You wouldn't allow car to run poorly for a week without seeking help. Don't let pain from overuse injuries cause you to move poorly and limit your activity.
Consult your local movement expert for tips on how you reduce the risk of these injuries.
Move Well, Move Often
-Jeff
References
Williams, Prentice. "Mechanisms and Characteristics of Musculoskeletal and Nerve Trauma." Principles of Athletic Training. 15th. McGraw Hill, 248-249. Print.
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