Treatment for Tendinitis/ Tendinosis

Last blog we discussed the differences between tendinitis and tendinosis, now we will discuss treatments. By the time you feel pain from tendinosis, your injury has been gradually building for many weeks or months. Remember that tendons heal slowly, due to limited blood supply. You will probably need to wait several months before a reasonable amount of repair has occurred, so have patience with this slow healing process. While both conditions are classically treated with conservative measures, the difference in care is absolutely critical to resolution of the problem. Conservative management stems around rest and anti-inflammatory medication for tendinitis, while conservative management of tendinosis aims to restore tendon regrowth and strength through manual therapy and eccentric exercise.

You'll need to avoid activities that cause pain, which can be a problem when some of those activities involve your work. Keep doing the normal daily activities that don't cause you pain. Treatment for tendinitis can be simply RICE (rest, ice, compression, elevation) to reduce inflammation and allow healing.

Braces are often used for the wrist, elbow, knee, and ankle. Some people find that braces can add stability and support during activity. Braces should not be worn all the time because you can lose strength and flexibility, but they can be helpful if worn part-time. This can be done for work or at night with wrist braces for carpal tunnel symptoms.

Stretching and strengthening with emphasis on eccentric exercise is especially helpful for tendinosis. Muscle is forced to lengthen while it contracts because it is being used as a brake or to absorb energy while doing "negative work." On the other hand, concentric exercise is when a muscle shortens as it contracts because it is acting as an engine doing "positive work." 

Correcting ergonomic problems can be very helpful in healing workplace tendinosis. Some foods and supplements, such as ginger and turmeric, can help reduce inflammation. 

 Your best bet is to maintain a healthy weight and eat a plant-based diet with plenty of antioxidant-rich whole fruits, vegetables, nuts, legumes, and grains, while eating minimal amounts of trans-fats, saturated fats, and simple carbohydrates.

Traditional treatments involve use of anti-inflammatories, corticosteroid injections, and/or pain medication for the treatment of tendonitis. It has been proven that these can actually further the degeneration of tendons and increase the risk of recurrence of the condition as well as increase the risk of tendon rupture. That being said, corticosteroid injections and anti-inflammatory medications have been shown to be effective in short term pain reduction for tendinitis.

Soft tissue mobilization can speed healing, restore proper collagen synthesis, strength and function. Chiropractic helps by aligning joints properly around the problem area which puts less stress on tendons. You then can break down the adhesions / restrictions and allows the tendons to heal properly. After an injury the body makes scar tissue to heal the area quickly but this must be broken down to allow proper healing of the tendon. If this is not done, tendons can weaken and rupture. I utilize soft tissue techniques such as Graston and ART and ultrasound therapy. These help breakdown adhesions/ scar tissue and stimulates collagen synthesis to heal tendinosis. If you or a loved one is having these problems call to book an appointment to get on the road to recovery. 

Dr. Stephen Kelly practices at Family First Chiropractic, 142 Erickson Drive, Red Deer, Alberta. 403-347-3261. www.family1stchiro.ca.