A question that I am frequently asked is do I have tendinitis or a tendinopathy, sometimes just to confuse you I will call it a tendinosis. So all these conditions with tendons, what’s the difference? Firstly, tendon – itis/ opathy/ osis are often used interchangeably by patients and clinicians. It is important for practitioners to distinguish between these disorders to apply the most appropriate treatment and it is important for patients to understand the process to allow the best outcome.
Tendinitis – inflammation of the tendon and results from micro tears that happen when the musculotendinous unit (parts were muscle and tendons meet) is acutely overloaded with a force that is too heavy or too sudden (Bass E/ tendinopathy: Why the difference between tendinitis and tendinosis matters).
Tendinosis – degeneration of the tendons collagen in reponse to chronic overuse; when overuse is continued without giving the tendon time to heal and rest. Most commonly conditions are diagnosed or labeled tendinitis when there is actually tendinosis. So does that mean those anti-inflammatory tablets you have been taken are effective?
So in short tendinitis is an acute inflammatory process whereas osis/ opathy is more chronic injury to the tendon.
Confusion can be caused as both conditions can exist together and persistent tendinitis can cause chronic changes in the tendon itself. A major issue is often overuse injuries that may have acute tendon pain, but from a biological point of view there is already a chronic failure of healing in the tendon. So you get there term TENDINOPATHY from a failed healing response.
How do we treat acute symptoms?
- REST
- ICE
- STRETCHING
- TENDON PROTECTION i.e. not exposing it to too much load (activity)
A theoretical explanation for tendon injuries “suggests a continuum of events – including less than usual blood supply (hypovascularity) and repetitive micro trauma that results in localised tendon degeneration and weakness. So our treatment often centers around eccentric strengthening exercises and increasing the tendons ability to handle load. Your physiotherapists will also look at any biomechanical issues that may cause you problems.
Our physios are experts in running biomechanical analysis and gait correction so pop in for an assessment and even progress to a complete running program.
