There are many different conditions I see as a BJC Health physiotherapist every day, but one of the most challenging to manage would arguably be a group of injuries known as tendinopathies.
A tendinopathy is defined as any disease to the tendon, which can cause pain, swelling or tenderness. Common sites of tendinopathies are at the heel (plantar fascia), Achilles and elbow (common extensor and flexor tendons).
A tendinopathy occurs when there are changes to the load and stress placed on the tendon. Some examples of when the load would be increased through a lower limb tendon would be with increased body weight or increased activity such as walking, running and jumping. Conversely, tendinopathies can also occur when there is reduced load through the tendon.
This above is considered a mechanical tendinopathy.
Working alongside rheumatologists has taught me that tendinopathies can also play a part in inflammatory disease. Certain forms of inflammatory arthritis such as ankylosing spondilitis, rheumatoid arthritis and psoriatic arthritis can manifest itself as tendon disease.
It is highly critical that a differentiation be made between mechanical and inflammatory causes for tendinopathies as this will change a patient’s management.
In cases of tendon disease caused by inflammatory arthritis, it is important for me to work with my rheumatology colleagues. Apart from managing how much load my patients put through the tendon (as in the case of a mechanical tendinopathy), we also need to manage the inflammation in the patient’s body, usually through prescribed medicine.
With patience, tendinopathies can be managed well allowing patients to return to their chosen activity pain free.
Please share any stories that you have had associated with your tendons and how you managed it, we'd love to hear them!
Continue reading about tendinopathies here: