Tendinosis, often termed as chronic or long term tendonitis, happens with constant, repetitive damage to a tendon at a cell level, causing slow, constant damage and degeneration without any inflammation (meaning it can happen with little to no swelling).
Our patients often complain of persistent pain, without any signs of swelling, but the spot is often tender. Some of our patients come to us with partial or fully ruptured tendons, as the damage and degeneration had become so severe that the tendon snapped when they moved. When this happens we need to fully rest the tendons by splinting the injured joint as well as immobilizing the top and bottom joints below it, if available. An example is splinting the ankle and foot for the chronic achilles tendonitis.
Usually, for patients with a tendinous micro tears or partial ruptures, we can discover simply by observing the way they move, or by clinically observing or joint, or by palpating the tender spot. Magnetic resonance imaging and/or ultrasonography will further confirm the presence of the injuries.
Our patients will often present with constant complains of joint stiffness, sometimes burning, aching at the same spot, or at the same tendon. Sometimes there's swelling, sometimes not. But the one thing that is constant is there is an increased level of swelling + plus after any activity, resulting in increased stiffness and pain the next day or even during the next hour.
Also, interestingly, some of our patients when presenting to us with this injuries, reports that it is during a stressful moment in their life where they start to notice this symptoms. Upon reflections, stress induces the a response where muscles tends to tighten up, effectively stretching tighter and more taut any tendons that links to them. If these patients de-stresses by rigorous activities, when coupled together, almost ends up with extra damage to the tendons, with resultant tendinosis over a period of time.
Physiotherapy Treatment of Tendinosis
Because of their physical and physiological nature, tendons heal very slowly (they don't receive direct blood supply and nutrition, but indirectly through tendon sheaths, unlike the blood-rich muscles), and tend to re-injure easily because of their role in the movement of the body/body parts. Any forms of tears (micro, partial or full) results in the body repairing the site by plastering it with a form of disorganized collagen fibres, which is weaker than normal tendon, resulting is almost always recurring of tendon injuries.
When treating our patients with tendinosis, we are generally more conservative. Our partnering medical professionals often prescribe NSAIDs (non-steroidal anti-inflammatory drugs), and we provide the exercise therapy, gentle active and passive stretching to maintain joint and muscle integrity, pushing patient to rest a lot during the acute stage plus icing and elevation to manage swelling and pain.
Patients often take about 3-5 days for the acute symptoms to be relieved, and full recovery takes about 2-3 months, varying from individual to individual (some individuals recover pretty fast, some take longer than the usual, this is common variances).
Other patients share this following advices, as advised by family, friends and their own doctors.
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