Osteopaths DON’T just treat spines (Part 9: tendons matter too)

Tendons are the name for the tissue that attaches our muscles to nearby bones. They enable us to move around. Without tendons, our muscles would not be able to pull our bones around.

Just like muscles, joints and nerves can become irritated at other times. The technical umbrella term for tendon issues is tendinopathy (which includes tendon or tendon sheath issues).

Fortunately, tendons rarely become pathologically inflamed, which is good as it often takes a year or more for an acutely inflamed tendon to calm down. however, tendons do commonly get irritated.

Why tendons can become irritated or inflamed:

Develops after you…
-> do too much too quickly after a period of not doing enough. <- In other words, tendons that lack endurance get irritated easier than fatigue-resistant, “tough” tendons. So when we jump into a new physical job or sport without building up our muscular-tendon endurance beforehand, the tissue gets irritated. TWO TREATMENTS I DO NOT RECOMMEND: 1: oral Paracetamol + Ibuprofen 2: excessive direct hands-on work on the tendon 1: Oral NSAIDs rarely reduce tendon pain, and they can have negative side effects: NSAIDs can slow down the healing process of tendons (2) NSAIDs can cause digestive distress (3) 2: Deep tissue treatment applied directly on a tendon inflames tendons. IF the tendon is just irritated then it can kick start the healing process. But if the tendon is inflamed it’s akin to adding fire to fire. 3 SHORT TERM TREATMENT options I do recommend: 1a: Avoiding activity that overuses problematic tendon/muscle 1b: Redistributing load away from an area that is overworking 2: Topical cream 1a: Rest (position of ease) The yin to the yang of contracting a muscle is to relax the muscle. Straps and braces for tennis elbow (a tendopathy of the elbow) work by making the overworked muscle unable to tense. To be frank, tendons do NOT get better unless you stop doing the things that aggravate it. 1b: Redistribute load: I generally treat RSI (tendon and/or muscle overuse) indirectly. Through redistributing biomechanical load area from the inflamed area. This gives the body a chance to heal itself. 1b1: waking up a lazy neighbouring muscle, so that the overworked muscle can take it easy. 1b2: relaxing (without overly irritating) the overworking muscle if it is chronically tense. 2: topical cream (1) Anti-inflammatory creams fall into two categories: 2a: creams that stop the inflammatory healing process, reducing pain in the process. 2b: Creams that aid/speed-up the healing process. 2a: Traumeel is my favourite anti-pain cream as it doesn’t inhibit the healing process. 2b: Tiger balm and diclofenic ( Voltaren) cream/gel. LONG TERM APPROACHES Long term approaches are all about increasing load tolerance: @gabbetttim says “it’s not the load that breaks you down, but the load your not prepared for.” Tendons are designed to handle load, but “if don’t use it you lose it.” 1: Pacing activity 2: Rehab 1: pacing is where you slowly INCREASE the intensity and workload of a job or sport over a period of time 2: Physios commonly prescribe, Eccentric dominant rehab exercises for tendon issues. These are impactful exercises, that isolate a muscle and tendon in a direct way. REFERENCES: 1: https://www.painscience.com/articles/voltaren-gel.php 2: https://www.sports-health.com/sports-injuries/general-injuries/what-difference-between-tendonitis-tendinosis-and-tendinopathy?fbclid=IwAR3kMiqq5CN39IY4WdTqZ3QvLpdMio_LluYSmlq1kD3y-qvOsMG2zW0Izts#.Wk69D3AObuo.facebook 3: https://www.nhs.uk/conditions/nsaids/