Treating Tendon Injuries

Tendon injuries are common in the sport community and can affect amateur and professional athletes alike. Tendon injuries are most often the result of gradual wear and tear to the tendon from overuse, incorrect movement or aging. As debilitating as they can be, the good news is that when treated properly, minor to moderate tendon injuries can heal on their own.

While almost any tendon can sustain an injury, the most commonly occurring tendon injuries in sport are:

• "Swimmer's shoulder"- occurs when the tendons in the shoulder muscles become weakened and inflamed, sometimes resulting in a rupture.
• "Tennis elbow" - is a condition when the tendons in your elbow are overworked, usually by repetitive motions of the wrist and arm.
• "Jumper's knee" - also known as patellar tendonitis or patellar tendinopathy is an overuse injury that involves the patellar tendon, the cord-like tissue that joins the patella (kneecap) to the tibia (shin bone).
• "Achilles heel" - probably the most well-known injury, involves inflammation of the large tendon at the back of the heel.

There are three stages of injury progression:

1. The reactive phase, where no overt signs of injury are apparent but if an athlete is training heavily, good prevention measures mean allowing adequate rest and recovery. 
2. The second stage is tender-to-the touch, tendons are progressing into a state of disrepair, usually coupled with inflammation and pain. Pro-active methods for recovery are recommended, icing and a longer recovery period is required. 
3. The third stage occurs when the tissues start to degenerate and are more likely to rupture with continued demand for force. If left to this state, it is not likely that an athlete will be able to progress in their training. Proper treatment requires a clinical diagnosis and a strict recovery plan.

When recovering from a tendon injury, full immobilization is not recommended - some movement is necessary for repair (depending on the severity), therefore allow relative rest, meaning minimal load bearing and reduced activity. Any activity that causes pain to the injury should be avoided while allowing the body to heal. If pain persists or becomes chronic, please contact your physician for treatment.

References from the SIRC Collection:

1. Bjöörnsson H, Norlin R, Johansson K, Adolfsson L. The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears. Acta Orthopaedica. April 2011;82(2):187-192.
2. Lin W, Weiwei G, Kaiyu X, Ning L, Bo W. The effects of an early return to training on the bone-tendon junction post-acute micro-injury healing. Journal Of Sports Science & Medicine. June 2012;11(2):238-244.
3. Nessel E. Athletes Needing to Treat Sore Muscles and Tendons. ASCA Newsletter. April 2010;2010(4):24-27.
4. Tonoli D, Cumps E, Aerts I, Verhagen E, Meeusen R. Incidence, risk factors and prevention of running related injuries in long-distance running: a systematic review. Sport & Geneeskunde. December 2010;43(5):12-18.
5. Teramoto A, Luo Z. Temporary tendon strengthening by preconditioning. Clinical Biomechanics. June 2008;23(5):619-622.
6. Witvrouw E, Mahieu N, Roosen P, McNair P. The role of stretching in tendon injuries. British Journal Of Sports Medicine. April 2007;41(4):224-226. 
7. Wren T, Beaupre G, Carter D. Tendon and ligament adaptation to exercise, immobilization, and remobilization. Journal Of Rehabilitation Research & Development. March 2000;37(2):217-224.