In this article, you will find out everything you need to know about tendon injury and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
Are you trying to look for the best way to treat your tendon injury? In this article, we provide you with all the information you need to first understand what a tendon injury is, and then what is required to provide pain relief and to help it to heal without surgery.
What is a tendon injury?
A tendon injury is classed as damage or inflammation located within the soft-tissue structure that helps to connect muscle to bone. Tendons are similar to ligaments in the sense that they are both connective tissue and made up of collagen, but ligaments have no relationship with muscle and just connect bone to bone. The collagen fibers in tendons are tightly packed and run parallel with each other. This tightly packed formation helps them to withstand force and keep a joint stable during movement. Tendons have a poor blood supply which is why they can be so vulnerable to injury and also the reason why they struggle to heal very quickly. The majority of injuries occur close to joints. There are three main types of tendon injury:
- Tendinitis – inflammation or irritation of a tendon, typically from overuse. This is most common in the following areas of the body:
- Flexor tendons in the elbow, clinically known as tennis elbow or lateral epicondylitis.
- Extensor tendons in the elbow, clinically known as golfer’s elbow or medial epicondylitis.
- Supraspinatus tendonitis – problems with this tendon can also affect bursa in the same area.
- Patellar tendonitis – this can also affect the infra-patellar bursa.
- Quadriceps tendonitis
- Gluteal tendinopathy
- Hamstring tendonitis
- Tendinosis – is where the collagen of a tendon degenerates as a response to chronic overuse.
- Rupture or tear – this is when fibers of the tendon have completely torn or partially torn. The most common tendon to suffer from a complete rupture is the Achilles tendon. Tendon tears can often accompany ligament injuries and sprains. For example, an inversion sprain of the ankle ligaments can also cause damage to the tendons.
Tendinitis and tendinosis may also be referred to as tendinopathies.
Symptoms of a tendon injury
You may experience one or more of the following signs and symptoms:
- Pain – this often gets worse with activity. Some tendon injuries can cause sharp pain during certain movements. For example, a tendinopathy of a rotator cuff tendon.
- Stiffness – normally experienced several hours after activity or the day after activity.
- Night pain and stiffness – resulting from a build-up of inflammation when the tendon isn’t moving.
- Tenderness
- Swelling
- The tendon may feel warm
- Clicking and crunching – if the tendons are tight then they can make a sound as they flick over bony prominences.
- An audible snapping sound at the time of the injury – this is normally only for full tears of the achilles tendon.
Causes of a tendon injury
The majority of tendon injuries are associated with repetitive activities such as typing, running and tennis. Our muscles were designed to absorb most of the force during a movement, but if they are tight or weak then a lot of that force ends up transferring into our tendons, causing inflammation. The poor blood supply of a tendon means that they recover very slowly. If the repetitive activity is repeated on a continual basis without giving enough time for the tendon to recover then it leaves some of the fibers in the tendon vulnerable to tearing. For example, if a tennis player is playing tennis a few times a week without stretching or massaging his forearm muscles.
Risk factors
- Tight muscles – performing activities without stretching before and after.
- Age – muscle fibers become more rigid as you age so more force ends up transferring into tendons. Also, blood supply to tendons starts to decline so the recovery rate slows down even further.
- Misalignments – if your joints are misaligned it causes your tendons to work at angles that they weren’t designed to.
How is a tendon injury diagnosed?
The majority of tendons are diagnosed with an ultrasound scan. If more specific detail is required then an MRI scan can be performed. X-rays cannot show tendon injuries.
Treatment
Due to their poor blood supply, tendons don’t recover and repair as quickly as other structures that have a good blood supply do. The main reparative compounds of blood are oxygen and nutrients. Prolotherapy is a treatment that involves the injection of a regenerative solution into an injured tendon. This helps to stimulate the production of fibroblasts. Fibroblasts help to secrete the collagen needed to repair and strengthen injured tendon tissue. The injected substance is very thin so it has the ability to spread into the injured area much more effectively than other types of injections.
The following video testimonial is of a patient of ours called Dean. He came to the clinic suffering from shoulder and elbow tendonitis.