Whether You’re an Athlete or a Couch Potato, You’re at Risk of a Tendinopathy

In my work as a physiotherapist specialising in tendons, I help everyone from athletes and ballet dancers to working professionals and retirees recover from complex tendinopathies which hold them back from being able to achieve their goals and enjoy life to the full.

A significant part of my work is not just treating, but educating. The more you understand your body, the more quickly you’ll be able to recognise the warning signs of tendinopathies and reduce your risk of one developing.

Here are some simple answers to the most common questions I’m asked about tendinopathies, and if you ever want more detail you can always get in touch with the clinic at info@conventgardenphysio.com.

What is a tendinopathy?

A disease of your tendon is called a tendinopathy. There are a wide variety of tendinopathies, but they can be broadly separated into acute tendinopathies, which typically result from trauma, or chronic tendinopathies, which develop gradually.

What causes tendinopathy?

Tendinopathies usually develop due to a load problem, either suddenly putting them under too much load or going a long time without putting them through enough. This puts athletic and sedentary populations alike at risk of developing tendinopathies.

For example, if you spend most the year at your desk then decide to take on marathon training, this sudden increase in load on as-yet-untested tendons will very likely result in injury if you don’t start training very, very gently.

Or, at the other end of the scale, if you’re an athlete or physical performer, years of training could gradually overload your tendons until the wear and tear outstrips the rate at which the tissue can repair itself.

There are other, rarer causes for tendinopathy, but overload is the most common.

How can I tell if I have a tendinopathy?

Early management is key to treating tendinopathies. Intervening soon after symptoms appear is the difference between a few days of recovery versus months of rehabilitation.

Recognising and responding quickly to the symptoms of a tendinopathy significantly reduces the duration and improved the outcome of your treatment.

Acute tendon injuries are more likely to be painful in the mornings and gradually ease as the day goes on, while chronic tendinopathies present pain which persists throughout the day and can significantly impede movement in the affected joint.

Tendinopathies may also cause tendons to feel hot and inflamed, while some aren’t painful or inflamed at first, with tendons that are swollen and stiff but present no other symptoms.

If any of the above symptoms present themselves for more than a few days you should book an appointment with a physiotherapist immediately.

How are tendinopathies treated?

Tendon tissue is far more solid than muscle, as you can feel yourself if you compare the two. This density means that tendons have very poor blood supply, which is why  tendons take far longer to heal compared to rapidly-repairing muscle.

Treatment programmes for tendinopathies involve very gradual and controlled rehabilitation, slowly strengthening the affected tendon and restoring mobility to the joint while also giving the tendon plenty of time to repair.

Muscles attached to injured tendons may also have become stiff, in which case we will loosen the muscle through manual therapy, tissue release, stretching or dry needling.

The controlled pace of tendinopathy treatment can be frustrating for athletes or performers whose livelihoods or passions demand physical activity, so we try wherever possible to tailor our rehabilitation to balance recovery with your fitness goals.

If progress isn’t being made with conventional physiotherapy, we may refer you for shockwave therapy, injections or, in the most severe cases, surgery.

How can I reduce my risk of developing a tendinopathy?

Underuse or overuse are by far the most significant risk factors for the development of tendinopathies.

If you’re currently living a sedentary lifestyle, slowly incorporate more activity into your life, ideally with the guidance of a physiotherapist or other fitness professional.

On the other hand, if you’re very active, always bear in mind the additional time tendons take to repair compared to your muscles and moderate your load accordingly. A general recommendation is no more than a 10% increase in load per week.

As with many injuries, excess weight increases load on tendons, while hormonal changes have also been shown to contribute to the development of tendinopathies, increasing risk in women going into menopause or people undergoing hormone replacement therapy.

All the above risks can be reduced or compensated for with help from the team here at Covent Garden Physiotherapy. If you would like to book your appointment, get in touch now at info@coventgardenphysio.com,  call 0207 497 8974, or book online

Juncal Roman

Specialist Sports, Dance and Musculoskeletal Physiotherapist.