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A common phrase that people use to describe their pain or injury is, “Oh it’s just a little tendonitis, it will go away soon.” Chronic tendonitis without treatment could ultimately lead to a complete rupture of the tendon sidelining you from any activity for months. In the past 10 years there has been substantial research into tendon pathology and the term “tendinopathy” has replaced the old term “tendonitis” as a result of the research and we now have a better understanding of the pathophysiological mechanisms. Through study and research, it has been concluded that there are 3 stages to tendinopathy: 1) reactive tendinopathy 2) tendon dysrepair and 3) degenerative tendinopathy.
Reactive tendinopathy is the early stage of tendon dysfunction and is a short-term adaptive thickening in attempt to reduce the stress placed upon the tendon. In this stage, the tendon can revert back to normal structure if overload is reduced or sufficient time is given between loading. Tendon dysrepair, there is greater matrix (tissue composition) breakdown of the tendon. We see this in all ages of patients and activity levels. In this stage, the tendon appears thickened with more localized changes. Degenerative tendinopathy is the last and most dangerous stage of tendon dysfunction. There is greater matrix and cell breakdown, with even some areas of cell death in this particular stage. If gone unchecked, this stage can inevitably lead to rupture.
Due to the fact that tendonitis/tendinopathy is an overuse injury, the best course of action is to decrease the stress and overloading of the tendon. In other words, REST. Also, through specific treatment interventions including soft tissue mobilization, eccentric strengthening, and evaluating the ultimate cause of the tendon dysfunction, we can prevent any further damage done to the tendon. If you are experiencing any sort of joint pain or “tendonitis” pain, come in and see one of our Doctors of Physical Therapy for a thorough evaluation to determine the best course of treatment for your particular injury.
Brannon Chester, DPT
Doctor of Physical Therapy