Tendinopathy is a condition that affects the tendons, which are the fibrous structures that connect muscles to bones. It is characterised by pain, tenderness, and weakness in the affected area, and can occur as a result of overuse, injury, or degeneration. Tendinopathy is a general term that refers to a range of conditions affecting tendons, including tendonitis and tendinosis.
Tendinitis is an acute condition characterised by inflammation of the tendon. It is often caused by a sudden injury or overuse, and typically presents with pain, swelling, and stiffness in the affected area.
Tendinosis, on the other hand, is a chronic condition characterised by degeneration of the tendon tissue. It is usually caused by overuse or repetitive strain, and tends to develop gradually over time. Symptoms of tendinosis include pain, weakness, and stiffness in the affected area.
Both tendinitis and tendinosis can occur in any tendon in the body, but they are most common in the shoulders, elbows (tennis elbow), wrists, hips, knees, and achilles tendons.
What is the treatment?
Treatment for tendinopathy typically includes a combination of physiotherapy, rest, and medication. Physiotherapy can help to reduce pain and inflammation, and improve strength, flexibility, and range of motion in the affected area. Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) may be used to help reduce pain and inflammation. In more severe cases, a surgical intervention may be necessary.
In order to prevent tendinopathy, it is important to use proper techniques when engaging in activities that put stress on the tendons, and to avoid overuse and repetitive strain. Additionally, maintaining good overall fitness through regular exercise and a healthy diet can help to reduce the risk of developing tendinopathy.
Physiotherapy for posture and biomechanics
Posture and biomechanics play a critical role in the development and management of tendinopathy. Poor posture and improper mechanics can lead to overuse, repetitive strain, and increased stress on the tendons, which can increase the risk of developing tendinopathy.
In the assessment of tendinopathy, a physiotherapist will typically perform a thorough evaluation of the patient’s posture and biomechanics, including:
- Postural assessment: The physiotherapist will assess the patient’s posture, looking for any imbalances, muscle tightness, or compensations that may be contributing to the tendinopathy.
- Biomechanical analysis: The physiotherapist will observe the patient’s movement patterns and assess their biomechanics during activities such as walking, running, or performing specific tasks. This will help to identify any movements that may be putting excessive stress on the affected tendon.
- Muscle testing: The physiotherapist will test the patient’s strength and flexibility to determine any muscle imbalances or weakness that may be contributing to the tendinopathy.
Based on the results of the assessment, the physiotherapist will develop a treatment plan to address any posture and biomechanical factors that may be contributing to the tendinopathy. This may include:
- Corrective exercises: The physiotherapist may prescribe exercises to improve posture, balance, and muscle strength.
- Biomechanical retraining: The physiotherapist may provide education on proper technique and movement patterns to help the patient avoid overuse and repetitive strain.
- Postural correction: The physiotherapist may provide advice on posture correction, such as using a lumbar roll or ergonomic modifications to the workstation.
By addressing posture and biomechanical factors, the physiotherapist can help the patient to reduce the risk of re-injury and improve their overall function and well-being. Regular re-assessment and adjustment of the treatment plan will be necessary to ensure the best possible outcome for the patient.
Physiotherapy for Achilles tendinopathy
Achilles tendinopathy is a common condition that affects the Achilles tendon, which is the large tendon that connects the calf muscle to the heel bone. Physiotherapy treatment for Achilles tendinopathy typically includes a combination of the following:
- Exercise therapy: Specific exercises are prescribed to improve strength, flexibility, and range of motion in the affected area. This may include calf stretching, eccentric strengthening, and plyometric exercises.
- Manual therapy: Techniques such as soft tissue mobilisation, joint mobilisation, and dry needling can be used to reduce pain, inflammation, and muscle tightness.
- Modalities: Treatment modalities such as ultrasound, electrotherapy, and laser therapy can be used to reduce pain and inflammation, and promote healing.
- Education and advice: The physiotherapist will provide education on proper technique, injury prevention, and self-management strategies. They may also provide advice on the use of assistive devices, such as ankle braces or orthotics.
- Home exercise program: The physiotherapist will work with the patient to develop a home exercise program tailored to their specific needs.
- Re-assessment: The physiotherapist will regularly reassess the patient’s progress and make adjustments to the treatment plan as needed.
The specific treatment approach will depend on the type and stage of Achilles tendinopathy, as well as the patient’s individual needs and goals. In some cases, a combination of physiotherapy and other treatments, such as medication, bracing, orthotics, and in some cases surgery may be necessary.
Other treatments for Tendinopathy
The role of physiotherapy in the management of tendinopathy is to address the underlying causes of the condition, reduce pain, improve function, and prevent recurrence. Other physiotherapy treatments for tendinopathy typically includes a combination of the following:
- Exercise therapy – Based on the physiotherapist’s findings, specific exercises are prescribed to improve strength, flexibility, and range of motion in the affected area. This may include stretching, strengthening, and functional exercises.
- Eccentric loading – this is a type of exercise that emphasizes the lengthening of a muscle while it is under tension. This type of exercise is commonly used in the treatment of tendinopathies, as it has been shown to be effective in reducing pain and improving function. During eccentric loading, the muscle is gradually lengthened in a controlled manner, generating resistance against the stretching force. This type of exercise can be performed with weights, resistance bands, or through body weight exercises.
Examples of eccentric exercises for the Achilles tendon include calf raises, heel drops, and single-leg squats. Eccentric exercises are typically performed in a slow and controlled manner, with a focus on proper form and technique. Eccentric loading is thought to be beneficial for tendinopathies because it promotes the growth of new tissue, improves the load-bearing capacity of the tendon, and reduces pain and inflammation. However, it is important to start these exercises gradually and under the supervision of a qualified physiotherapist, as improper technique or overloading can cause further damage to the tendon.
- Taping – is a common technique used by physiotherapists to provide support and relieve pain associated with tendinopathies. The goal of taping is to reduce stress on the affected tendon, improve biomechanics, and provide pain relief. There are several different taping techniques that can be used for tendinopathies, including:
- Kinesiology taping: This type of tape is designed to mimic the stretch and recoil properties of skin and muscle, providing support without restricting movement.
- Rigid tape: This type of tape provides a more rigid support, which can be helpful in reducing stress on the affected tendon and improving biomechanics.
- McConnell taping: This taping technique is commonly used for Achilles tendinopathies, and involves applying tape to the calf muscle to reduce stress on the Achilles tendon.
The specific taping technique used will depend on the type and stage of tendinopathy, as well as the individual needs and goals of the patient. Taping should be used in conjunction with other physiotherapy interventions, such as exercise therapy and manual therapy, for the best possible outcome.
It is important to note that taping is not a cure for tendinopathy, but rather a supportive intervention that can help to reduce pain and improve function. Regular re-assessment and adjustment of the taping technique may be necessary to ensure the best possible outcome for the patient.
The specific treatment approach will depend on the type and stage of tendinopathy, as well as the patient’s individual needs and goals. Our physiotherapists at Home Physio Group can work with patients to develop an individualised treatment plan that considers the patient’s diagnosis, symptoms, and overall health status. Physiotherapy can also be used in conjunction with other treatments such as medication, bracing, orthotics, and in some cases surgery.
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