What causes forearm, knee and ankle pain and what you can do about it
What is a tendon?
Tendons are the tensile white tissue at either ends of a muscle and attach the muscle to the bone. Tendons aren’t very flexible — they have developed to be thick, fairly rigid structures in order to transmit forces to and from the more flexible, contractile muscles.
Tendons are made of a fibrous blend of collagen (see our previous blog on scars) and elastin, which confers a degree of protective elasticity. Like any tissues in the body, they can be injured, causing different conditions with specific clinical features and healing times.
Tendinopathies: tendonitis vs tendinosis
Tendon injuries are commonly referred to as tendinopathies, which literally means any type of malfunction or issue affecting the tendon. Depending on the nature of the tendinopathy, these can be divided into tendonitis or tendinosis. Although the words are similar, the mechanics of these two injuries and their recovery time and process is very different.
Tendinitis refers to an acute condition affecting the tendon usually characterised by inflammation following trauma — typically causing swelling, redness, pain and stiffness. The trauma isn’t always direct or the result of an impact. It may be caused by excessive elongation (stretching) of the tendon during movement. This tears some fibres in the tendon often causing pain at the time (except in a complete tendon rupture which feels like a painless blow to the tendon) followed the inflammatory process.
Tendinosis is a chronic condition which isn’t the result of a single acute stretching or direct trauma but a process of wear and tear (degeneration) caused by repetitive microtraumas overtime. Natural ageing of tissues is the primary predisposing factor but other elements such as sedentary lifestyle, desk bound jobs or previous episodes of tendonitis greatly contribute to it.
Let’s talk about healing! Tendons have a poorer blood supply than muscles, which means they take longer to heal.
Tendonitis (acute injury) usually takes 3 to 8 weeks to heal depending on the severity of the trauma and number of tendon fibres affected.
Tendinosis (chronic injury) takes much longer, on average between 3 and 6 months.
In both cases, osteopathy and physiotherapy are the gold standard treatments. Osteopaths and physiotherapists are clinically trained to differentiate the nature of your tendon injury based on your case history and clinical examination.
Treatment usually consists of manual joint manipulation and soft tissue work often combined with a rehabilitation exercise plan. If appropriate, your osteopath or physiotherapist may suggest the use of functional taping and dry needling acupuncture to facilitate the recovery process.
The most common tendinopathies (either acute or chronic) are:
– Shoulder: known as rotator cuff syndrome
– Achilles tendonitis / Achilles tendonopathy
– Patella (knee cap) tendonitis
– Repetitive strain injury (RSI) of wrist and elbow tendons
– Gluteal muscles
If you suffer from any of the above conditions or if you think that you might have a tendon injury, please call our reception team to find out more about how we can help. Our physiotherapists and osteopaths can advise you on the best treatment course or refer you for further investigations (such as in tendon rupture) as appropriate.