The World Of Tendons

A tendon is a cord or band of dense, tough, inelastic, white, fibrous tissue, serving to connect a muscle with a bone. Think Achilles tendon, which attaches your calf muscle to the heel. Damage or injury to tendons is quite common. There is two different issues-tendinitis and tendinosis. One you’ve probably heard of before. The other, probably not. While they both sound the same, in reality they are worlds apart.

Tendinitis is, by definition, inflammation of a tendon.  Tendinosis on the other hand is defined as chronic tendinitis without inflammation and implies chronic tendon degeneration at the cellular level. Basically, one is short-term with inflammation, the other long-term, without inflammation, though both are caused typically by overuse. Repetitive strain injury (RSI) goes by a lot of names – it can also be called tenosynovitis or chronic tendinopathy by doctors. Don’t let their fancy jargon scare you! It’s kind of simple – tendinitis happens when you repeat a motion frequently on tight tissues and when the rate of damage exceeds your body’s natural rate of repair. 

NORMAL TENDON Uniform, Organized, & Parallel            

 

 

FRAYED TENDON (TENDINOSIS) Unorganized, Tangled, & Random

 

      

                         

Tendinitis, the most popular diagnosis of the two, usually presents with swelling and tenderness at the sight of pain, often accompanied by stiffness, and less often by weakness. Tendinosis presents most often with stiffness, tenderness to the touch, and weakness–almost identical to tendinitis. Recovery of tendinitis lasts anywhere from days to six weeks, a relatively “quick fix.” Tendinosis recovery can last a few short weeks to a couple months or more depending on the level of degeneration. If left untreated, tendinosis often leads to “tear” injuries

Tendinitis and tendinosis, both, occur most often in the Achilles tendon (ankle), patellar tendon (knee), proximal hamstring (high hamstring), common extensor tendon (elbow), and the supraspinatus tendon (shoulder). With both of these problems being so relatively close, while treatment is vastly different, proper diagnosis is vital to the recovery process! So which one do you have? Let’s go to the research.

While tendinitis is the wildly over-popular diagnosis among general practitioners, it may not be the case. Most research coming out on this topic is now showing that at a cellular level, once believed tendinitis actually is, in fact, tendinosis.

According to Almekinders and Temple, “Most currently practicing general practitioners were taught, and many still believe, that patients who present with overuse tendinitis have a largely inflammatory condition and will benefit from anti-inflammatory medication. Unfortunately this dogma is deeply entrenched. 10 of 11 readily available sports medicine texts specifically recommend non-steroidal anti-inflammatory drugs despite the lack of clinical evidence.”

In light of this, chances are that if you have been diagnosed with tendinitis the diagnosis was incorrect. Furthermore, traditional, conservative treatment, of such, with the use of anti-inflammatories, corticosteroid injections, and/or pain medication may have left you worse off long term even though pain may have dissipated short term. This is because these drugs inhibit collagen repair and are designed to eliminate inflammation, not regrow tendon. As mentioned above, treatment of tendinosis should be aimed at restoring tendon function and strength. Drugs will not help solve the problem! With all this said, while we cannot assume a tendinitis diagnosis was incorrect, lingering, worsening, or reoccurrence of pain would suggest that it may in fact be tendinosis. It is recommended that treatment plans geared toward tendinitis, in these cases, be re-evaluated.

Tendinitis is one of the most commonly diagnosed injuries and all too many struggle to find relief. With the proper diagnosis and treatment plan, it doesn’t have to be that way!

The next blog will discuss treatments for tendinitis/tendinosis. Stay tuned!

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

Do you have Sciatica? How we can help.

Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body. Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve.

Chiropractors are well educated to effectively treat sciatica. Patients describe the pain as dull, achy, sharp, toothache-like, pins and needles, shooting pains or electric shocks. Other symptoms associated with sciatica include burning, numbness and tingling sensations sometimes at night while sleeping.

Sciatica is caused by sciatic nerve compression or impingement. Health changes that can cause sciatic nerve pain include pregnancy and childbirth with the center of gravity biomechanical changes, lumbar spine subluxations, herniated or irritated discs, tumors, constipation and common cause of sciatica is piriformis syndrome. Piriformis syndrome is named after the piriformis muscle, this can refer pain into the low back are and mimic disc injury pain. The piriformis muscle is located in the lower part of the spine and sacrum and assists in hip rotation. The sciatic nerve runs most often beneath the piriformis muscle, it can however run over it or through the piriformis in some individuals. Injuries such as slips and falls can cause cramping and spasm to develop in the piriformis muscle, thereby pinching the sciatic nerve and causing inflammation and sciatic pain.

Chiropractors can fully assess and diagnose sciatica a piriformis syndrome, Since there are many disorders that cause sciatica, the chiropractor's first step is to do diagnostic testing which may include an x-ray, MRI, CT scan and other testing may be done.  

 A chiropractic sciatica treatment plan may include several different treatments including chiropractic adjustments, stretches, strengthening, ART, heat or ice therapy, supplementation of omega 3’s, B complex and magnesium. Some chiropractors may recommend a TENS unit (transcutaneous electrical nerve stimulation) to reduce the pain with out medications.

For more information call our office at 403-347-3261 and speak with Dr. Joelle Johnson at Family First Chiropractic and Wellness. 142 Erickson Drive, Red Deer, T4R2C3 www.family1stchiro.ca

Carpel Tunnel Syndrome

 Carpel Tunnel Syndrome (CTS) is the most common of the “entrapment neuropathies”—compression or trauma of the body’s nerves in the extremities and the cause of patients loses in medical bill and time off work.

Carpel Tunnel Syndrome (CTS) is a condition involving the median nerve. The median nerve originates in the cervical spine and runs into the forearm then the hand. If the median nerve were to get compressed somewhere along the nerve path CTS occurs. It is commonly thought that the nerve only gets trapped at the carpal ligament. This is a narrow tunnel at the wrist made up of bones and soft tissues, such as nerves, tendons, ligaments, and blood vessels. However, the nerve can also become impinged in the neck, elbow, or forearm. This could be a reason why all carpal tunnel surgeries sometimes don’t get the results as expected. The compression may result in pain, weakness, and/or numbness in the hand and wrist, which radiates up into the forearm. CTS is the most common of the “entrapment neuropathies”—compression or trauma of the body’s nerves in the extremities.

 Patient’s experience burning, tingling, itching, and/or numbness in the palm of the hand, thumb, index, and middle fingers. These are the most common symptoms. Since many people sleep with wrists flexed. Symptoms often first appear while sleeping. As symptoms progress, they may feel tingling during the day. In addition, weakened grip strength may make it difficult to form a fist or grasp small objects. Some people muscle atrophy at the base of the thumb, and are unable to distinguish hot from cold by touch. Usually occurs in adults, with women 3 times more likely to develop it than men. The dominant hand is usually affected first, and the pain is typically severe. CTS is common in assembly-line workers in manufacturing, sewing, finishing, cleaning, meatpacking, and similar industries, as well as pregnant women.

In addition patients that have smaller carpal tunnels than others, which makes the median nerve compression more likely. CTS can also develop because of an injury to the wrist that causes swelling. Over activity of the pituitary gland, hypothyroidism, diabetes, inflammatory arthritis, mechanical problems in the wrist joint, poor work ergonomics, repeated use of vibrating hand tools, and fluid retention during pregnancy or menopause. All of which could cause CTS.

CTS should be diagnosed and treated early. A Chiropractic examination of the hands, arms, shoulders, and neck can help determine if your symptoms are related to daily activities or to an underlying structural disorder. Doctors of Chiropractic are able to use other specific tests to try to reproduce the symptoms of carpal tunnel syndrome. Chiropractic adjustments of the spine and extremities where the nerve pressure occurring is the treatment of choice. Other recommendations include stretching and strengthening exercises soft tissue mobilization techniques, resting the affected hand or wrist. Immobilization of the wrist through a splint and applying cold packs to reduce swelling due to inflammation is also recommended. Proper posture and movement as instructed by your doctor of chiropractic can help prevent CTS recurrences. For the majority of carpal tunnel cases come into Family First. If you or someone you know is suffering from CTS, feel free to email the clinic at www.family1stchiro.ca or call us at 403-347-3261 for consultation and to set up a time to have your spine and nervous system checked.

Dr. Elton Clemence is a Chiropractor at Family First Chiropractic and Wellness, located In Red Deer, AB 142 Erickson Dr ,www.family1stchiro.ca 403-347-3261 to book an appointment.

Do you have Restless Leg Syndrome?

 Restless Leg Syndrome- RLS affects over 12 million people causing a strong urge to move ones legs especially at night. RLS is a neurological complaint causing a decrease of nerve impulse to the affected limb- most often the legs. This uncomfortable syndrome causes many people a lot of discomfort. A large portion of pregnant population suffers from this uncomfortable issue. RLS prevents you from getting adequate rest and good nights sleep. Sleep deprivation can cause weakening of the weakening of the immune system, mood swings, psychological effects and depression.

Symptoms of RLS 

·        Strange itching, tingling, or "crawling" sensations occurring deep within the legs; these sensations may also occur in the arms.

·        A compelling urge to move the limbs to relieve these sensations

·        Restlessness -- floor pacing, tossing and turning in bed, rubbing the legs

Many patients, pregnant and non-pregnant find relief from specific experienced chiropractic adjustments, especially when adjusting the pregnant spine. These adjustments remove any pressure, impingement or irritation to the affected nerves in the legs/limbs. A complete history, examination and assessment will rule out any other underlying issues that may cause RLS.

Home help: Stretching, Epsom salt baths, heat application, limb massage

Supplements: Folic acid, Magnesium, B12, B complex, homeopathies

Dr. Joelle Johnson has practiced in Central Alberta for over 17years in prenatal and pediatric chiropractic at Family First Chiropractic and Wellness, 142 Erickson Drive, Red Deer T4R 2C3 www.family1stchiro.ca 403-347-3261