Recent studies using advanced imaging have shown that, although tendons have poor blood flow, there is some low-grade inflammation. This is typical in reactive tendons which have been subject to abnormal loads and strains. But it is good news as this means that there is scope of tissue healing!!
This also supports the use of anti-inflammatory drugs over a short course, if symptoms need to be managed prior to commencing rehabilitation. However, the term ‘tendinopathy’ is preferred to collectively describe strains, partial tears and tendinitis.
Ultrasound or MRI?
In the early stages, there are no merits of imaging, unless a rupture is suspected or a differential diagnosis needs to be ruled out. Often, imaging studies do not change the treatment and there are more negatives, think patient perception of their pathologies, than positives. If conventional treatments fail, imaging maybe requested. Much of the tendon is actually still intact and likes to be loaded: treat the donut, not the hole!
Ok…! But what to do?
Once the integrity of tendon has been established, from the detailed history and thorough assessment, conservative treatment is still the best option and must be executed well and exhausted prior to any other invasive interventions.
How can we help?
Exercise prescription by a skilled physiotherapist is well-supported by various clinical trials and studies. We will slowly expose the tendon to various loads to increase the tensile strength of the intact tissue. This will be tailored to the client’s individual needs, whether this be playing sport or being able to walk around the shops. Progress is often slow, but adherence to exercise and education about condition reaps good results.
We are skilled at…
- Thorough subjective & physical assessment
- Establish pre-symptom activity load
- Factors influencing tendon load
- Establish individual fitness & activity goals
- Tailored, specific and progressive exercises
- Monitor progress at periodic intervals until symptom free.
In a nutshell, load management is the key. But this is a skill only a few are able to master! Our resident physios are skilled at this and are up to date with the latest research in this area to deliver results!
If you have any more questions, call us on 5367 4130
Author:
Shalin Patel /Clinical Supervisor
Back In Motion Bacchus Marsh
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