‘Tendon Injuries’ written by Michael Dermansky and published in Great Health Guide (August 2017). Tendon injuries are common and are still very difficult to treat despite the progress in the field of injury treatment. But why is that so? Tendon injuries require special attention and specialised treatment depending on the extent of the injury. Senior physiotherapist Michael Dermansky sheds some light on this topic of tendon injuries explaining some misconceptions about them and how best to recognise and treat these injuries.
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Fitness: Tendon Injuries
written by Michael Dermansky
Despite the sophistication of sports injury management and sports science, tendon injures are still a very tough area to treat. Over the last fifteen years, the best-known approach for managing tendon injuries has continued to change and thus the best method of treatment is yet to be defined. However, a large amount of information on tendon injuries is understood and at present, certain treatment methods are recommended for these injuries.
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Tendon injuries occur when there has been a fast change in how much work the tendon must do. For example, if an exercise program is increased too rapidly, such as, starting to run faster or more often, or if running up hills is added to the program, the tendons are placed under considerable stress. The tendons start to cause pain as the breakdown of the tendon occurs. These tendon injuries usually happen, when the load placed upon the tendon causes damage, that is greater than the repair and growth occurring at rest and after exercise. When an imbalance occurs between damage and repair, the tendon breaks down.
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Tendons break down at points where they are naturally compressed by bony structures. For example, when the hip is flexed over 90 degrees or sitting cross legged, the gluteus mediums tendon is compressed against the bone at the side of the hip. Avoiding these positions is part of the process of managing tendon damage and pain.
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Healing of tendons is slow. They do not heal well as they have a very poor blood supply. Thus, the treatment of the injured tendon requires a very well-structured progression of exercises, such that the load placed on a tendon is very light while the tendon is healing.
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This treatment must be carefully monitored and often begins with isometric exercises until such time as the tendon is pain free. Only then can regular exercises be carefully introduced.
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It is very important to address all the bio-mechanical factors that add additional load onto the tendon. For example, the treatment in addressing an Achilles tendon injury, will also mean improving the strength and control of the hips and knees. This will aid in reducing the load placed onto the tendon in the long term.
Because of complexity of rehabilitating a tendon after injury, I would highly recommend seeing a physiotherapist or exercise physiologist who is familiar with tendon injuries for the best chance of recovery.
Author of this article:
Michael Dermansky is a Senior Physiotherapist and Managing Director of MD Health Pilates. Michael has over seventeen years’ experience of treating clients from all walks of life, from six-year-old children up to the age of 92. Michael can be contacted through his website.
