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Chronic Tendon Pain

Chronic Tendon Pain 

Tendon pain is a common problem among active individuals seen in physical therapy practice. The most common sites for tendon pain include the elbow (involvement of the extensor muscles wrist and hand muscles), heel (achilles tendon), shoulder  (rotator cuff tendons) and the hip (gluteal tendons).

Tendon problems may begin as an inflamed tendon following exposure to excessive stress. Tendonitis is best treated with activity modification, ice, and if necessary, over-the-counter pain medication. In many cases, however, the acute injury leads to a more chronic problem involving tissue breakdown. Then a vicious cycle sets up whereby the now weakened tendon is less capable of withstanding stress, which leads to further degeneration. It is often at these later stages, when the condition is more serious, that people seek care. Now the problem is a Tendinopathy.

Understanding the nature of the problem is important in directing proper treatment. Medical treatment, at least in the past, has been centered on the use of anti-inflammatory medication. These medications, however, are not effective beyond the acute phase of the injury. Management of these types of injuries should start with an assessment of the stage and severity of injury, as well as evaluation for musculoskeletal impairments (muscle strength, joint range of motion).

Physical therapists evaluate and treat tendinopathy.  Physical therapists perform comprehensive physical assessments, and consider the condition in the context of the individual’s movement health as a whole.  They can determine how best to modify loading on the involved tissues in order to optimize healing and restore function. They utilize interventions that can help control pain, and will prescribe exercises to begin building the strength of the compromised tendon and muscle unit. They can also prescribe exercise to maintain function of the surrounding joints or musculoskeletal structures. Finally, they can provide guidance on return to normal activity or sports participation.

It is ideal to address tendon injury in the early stages in order to prevent a progression of the problem. If you do have a tendon condition that is not getting better, see your physical therapist. 

Marcia Spoto PT, DC, OCS

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