Tendinopathy: What It Is, How to Prevent It, and How to Treat It
Tendinopathy is a common condition that affects the tendons — the strong, rope-like tissues that connect muscles to bones. Tendons can become irritated or damaged when they are overused or stressed, leading to pain and difficulty moving. A well-known study by Cook et al. (2009) introduced a helpful way to understand how tendinopathy develops in stages, depending on how much stress or load is placed on the tendon over time. Knowing this can help you prevent and manage tendinopathy more effectively.
What Is Tendinopathy?
Tendinopathy, according to Cook et al. (2009), is best understood as a progression of tendon problems that happens in three main stages:
Reactive Tendinopathy: This is the early stage, where the tendon reacts to an increase in stress (like from exercise or repetitive movement) by becoming painful and swollen. This is a protective response, meaning the tendon is trying to cope with the added stress.
Tendon Disrepair: If the stress continues without proper care or enough rest, the tendon starts to break down a bit. The structure of the tendon begins to change, and the damage starts to accumulate.
Degenerative Tendinopathy: At this stage, the tendon has undergone significant changes and is less able to handle stress. The tissue becomes more disorganized, and there may be areas of weakness or thickening. This stage is more common in older adults or people who have had a tendon issue for a long time.
Understanding this progression helps us see that tendinopathy doesn’t happen overnight. It’s a gradual process where tendons get overloaded without enough time to recover.
What Causes Tendinopathy?
Several factors can contribute to tendinopathy, usually involving some form of repetitive stress or load:
Too Much Activity Too Soon: Doing too much, too soon, or repeating the same activity too often can overload the tendon. For example, suddenly increasing your running mileage or playing tennis every day without rest can cause tendinopathy.
Poor Technique: Using improper form during exercise or sports can increase stress on the tendons.
Aging and Wear: As we age, tendons naturally lose some of their strength and flexibility, making them more prone to injury.
Lack of Rest: Not allowing enough time for rest and recovery between activities can prevent tendons from healing and adapting, pushing them further along the tendinopathy continuum.
How to Prevent Tendinopathy
To prevent tendinopathy, it’s crucial to manage how much stress you place on your tendons and give them time to recover. Cook et al. (2009) suggest several strategies to help keep tendons healthy:
Gradually Increase Activity: Start new activities or increase exercise intensity slowly. Avoid sudden increases in how much or how hard you exercise. This gives your tendons time to adapt to the new load.
Eccentric Exercises: Focus on exercises where muscles lengthen while under tension, like slowly lowering your body during a squat or controlling the downward phase of a bicep curl. These exercises are especially good for strengthening tendons and helping them handle stress.
Rest and Recover: Make sure you have enough rest days and recovery time between intense activities. Rest is crucial for allowing tendons to repair themselves and avoid overloading.
Use Proper Form: Learn the correct techniques for your sport or exercise. This helps minimize unnecessary stress on your tendons.
Pay Attention to Pain: Don’t ignore pain in your tendons. If you feel pain, especially during or after activity, it’s a sign that you need to adjust your routine to avoid further damage.
How to Treat Tendinopathy
If you think you might have tendinopathy, treating it early is key to preventing it from getting worse. Here are some steps based on Cook et al.’s (2009) model:
Reduce Activity or Modify Movements: If you’re in the early stages (reactive tendinopathy), reducing the amount or intensity of the activity that’s causing pain can help. You don’t need to stop all activity, just modify it to reduce the load on the tendon.
Physical Therapy: A physical therapist can help guide you with specific exercises, particularly eccentric exercises that help repair the tendon. They can also help with manual therapy techniques and stretches to restore movement and function.
Rebuild Strength Gradually**: As the tendon heals, gradually introduce exercises that slowly increase in intensity to build up the tendon’s ability to handle stress again.
Advanced Treatments: If the pain persists and doesn’t improve with basic treatments, more advanced options like shockwave therapy, cupping, scraping, or dry needling might be considered to stimulate healing and help with muscular tightness and other symptoms.
Final Thoughts
Tendinopathy can be frustrating, but understanding the process of how tendons respond to stress can help you prevent and manage it. The key is to recognize the early signs, manage your activity levels, and allow for adequate recovery. Remember, it’s all about balancing load and rest to keep your tendons healthy. If you’re experiencing persistent tendon pain, reach out to us and we can help create a personalized treatment plan.
By taking proactive steps, you can stay active and enjoy your favorite activities without letting tendinopathy slow you down.
