My tendon issue is not settling, what is going on and how do I improve it? This blog will investigate causes of tendon pain, your treatment options, and hopefully explain why the lingering tendon pain is not going away.
What does a tendon do?
Tendons are designed to resist tension, transferring loading from the muscle to a bone to create movement. They also help absorb force from a bone into the muscle. Unfortunately tendons have a poor blood supply and therefore a much slower healing time. When you exercise and train, micro damage occurs in our tissues, bone, muscles, ligaments, tendons. This is a normal response and as a result our tissues grow back stronger. A tendons healing time takes slightly longer than other structures. This means that if someone trains again too much too soon, repetitively that micro damage could become a large problem.
What are common causes of tendon pain?
Common tendon issues include a full rupture, tears, tendon sheath inflammation and tendinopathies. Apart from a full rupture, other issues all present and are treated quite similarly. Many patients will complain of a lingering tendon pain that can be stiff and sore in the morning, worsens after activity and may or may not be painful at nighttime. They will find that rest will reduce their pain but as soon they increase activity again, their pain increases.
What are the treatment options for my tendon pain?
Exercise and a gradual loading program has been shown to be the gold standard for treating tendon issues however, there are a few simple things that can be done to help manage symptoms.
- Reducing aggravating activities: if you are constantly putting your hand in the fire, is it ever going to get better? The same occurs with tendon pain. If you are constantly aggravating the tendon and not allowing for a period of recovery how will symptoms ever improve. Traditionally running and jumping activities are the most aggravating for lower limb tendon issues and it does not mean you have to completely stop these activities. You may have to modify one or more factor for a period of time. This could include speed, distance, frequency, or reps.
- Stretching: tendons do not like to be compressed and it can cause them to become aggravated. Stretching a tendon can cause it to be compressed on structures around it. Stretching will also attempt to lengthen the tendon therefore compressing on itself. Stopping stretching will not fix the problem but it can help stop it becoming aggravated.
- Changing postures and position: depending on the tendon that is affected, certain positions can become aggravating for a tendon. For example, a proximal hamstring tendon issue is easily aggravated by sitting for long periods, for a desk worker this is difficult as it is required for their job. Switching to a standing desk or using a cushion can be a simple modification to stop aggravation, similarly, avoiding sitting with crossed legs or standing with a hitch hip can reduce the aggravation for a gluteal tendon.
As mentioned, these simple changes are not a substitute for proper advice and treatment from a physiotherapist but simple modifications to better manage symptoms. To fix the true cause of the problem, proper help should be sought from one of our highly trained physiotherapists.