Tendinopathy


Tendons! What are they?

Tendons attach muscle to bone. They transmit loads from muscle to bone for the purpose of motion AND stability. Tendons are STRONG. They are almost 100% collagen, that means they are strong, stiff and flexible. The fibers of a tendon are laid out in a parallel arrangement, allowing them to transmit tensile strength most optimally. Tendons are also surrounded by a sort of casing that aids in gliding and decreases friction.

When it comes to tendinopathies there are typically two types: tendinitis and tendinosis. Tendinitis is the one we all hear or think about when a tendon injury occurs. “-itis” means inflammation, so in tendinitis there is an inflammatory process happening to the injured tendon. With tendinosis there is little to no inflammation, but there is loss of collagen orientation from chronic injury to the tendon.

The amount of stress we put on our tendons depends on two major factors:

1. The size of a muscle and tendon

2. Whether the muscle is contracting

Muscle contraction alone will not rupture a tendon. Injury to a tendon is typically produced by trauma. The muscle is contracted, and a tensile force rapidly extends the muscle before it can relax. For example: rapid dorsiflexion (toes moving to the sky) of the foot when the gastroc is fully contracted (toes pointed) will cause a rupture of the achilles tendon. Tendons are 2X stronger than muscle, so muscle tears are more common than tendon tears.

After an injury to a tendon, healing occurs almost instantly. Your body starts to lay down layers of tissue to repair the tear. To avoid weakening of that tendon, and to prevent future injuries or loss of mobility, it is important to move that area. We want the fibers to be laid down in a parallel fashion, if not they will be laid down hap-hazard and the tendon won’t be as strong and more prone to injuries.

Pain-free exercises should be incorporated immediately to stimulate proper collagen placement. In our office we utilize eccentric strengthening (it is thought to stimulate collagen metabolism and synthesis best), joint manipulation (the adjustment) and IASTM to help mobilize scar tissue and increase its pliability.

Do you have a nagging tendon injury or have any questions? Give us a call or send an email, we are happy to help!