Tendinitis : What is it and how to fix it
A quick WebMD search for tendinitis can yield some disheartening results. The overall summary makes it sound like whatever body part hurts is going to fall off, need steroid injections, or be put back together with surgical thread and duct tape. Ok maybe not fall off, and maybe not duct tape — but the analysis of what tendinitis is makes it sound like it’s crippling and going to take you weeks to get back to doing what you want to do. It also makes it sound like your options for treating tendinitis are extremely limited and doesn’t seem like there’s much in the way of hope.
Well, that’s just not the case. There is a LOT you can do with tendinitis, and it doesn’t need to take weeks or months to go away.
Tendinitis ( or Tendonitis)
Tendinitis is an irritation and inflammation of a tendon, the connective tissue that attaches your muscles to your bones throughout your body. Usually, when someone says they “strained” or
“pulled” a muscle, this is actually what they are talking about. It often occurs when an abnormal load is placed on a normal tendon; when a normal load is placed on an abnormal tendon; or when the stress and demands placed on the tendon exceed what is capable of on a regular basis. It often presents as pain, tightness, and weakness of a muscle — especially when attempting to use the muscle. There may even be some swelling and tenderness to the touch.
In clinic, I follow this series of steps for treating a case of tendinitis : Relieve pain, Reduce irritation, Reprogram the movement, Return to strength. This program is not only effective, but much of it is given to my clients and performed at home.
Relieving pain in most cases of tendinitis is done in clinic through manual therapies and hands on soft tissue work, sometimes with the application of Rocktape as well. At home, this means using a foam roller, tennis ball, or similar type of self massage tool on the muscles that are sore and tight. The goal is to relieve some or most of the pain, not to fix the problem using just a foam roller — don’t get too focused on that part.
Reducing the irritation on the tendon is where you will have to start making some changes in order to heal. This might mean taking time away from the activity that causes most of the pain, or changing your activities. It could also mean adding stretches or mobility work for tight muscles and movements. Other methods might be using tape or braces/wraps for a few days to support the joint or muscle. While you are reducing irritation on the tendon, some level of rest is usually helpful. However, instead of complete rest I recommend that you work through the movements in a lighter, controlled fashion. This lets you keep working the tendon and acclimating the muscle to loading without causing pain or further damage.
Reprogram The Movement
Reprogramming the movement either requires fixing a dysfunctional movement pattern, or altering the specifics of your training program. One way that I approach the dilemma is this : if it hurts or is uncomfortable to do one or two repetitions — you probably need to fix the pattern. Otherwise, there’s a good chance that you need to alter your training program.
Return To Strengthening
Returning to strength is the last step, and is an important step for making sure that the issue doesn’t resurface. In clinic this is when we discuss and teach movements and exercises that support the muscle or joint and how to make it stronger. Making the whole area and overall movement stronger greatly reduces the likelihood of another bout of tendinitis. I also like to add in eccentric exercises to help strengthen the tendons and connective tissue. It’s important not to try this step too early, as it will go right back to irritating the tendon if you are not careful.
Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist.