John Orchard's Sports Injury Site
For transfer to my new extended site on cricket injuries or sports injuries in general, click:
http://www.cricketinjuries.com or http://wwwinjuryupdate.com.au
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John Orchard's Sports Injury Site For transfer to my new extended site on cricket injuries or sports injuries in general, click: http://www.cricketinjuries.com or http://wwwinjuryupdate.com.au
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What is tendonitis (tendinopathy)? Tendonitis means, literally, “inflammation of a tendon” and this is probably a bad name for the condition. Inflammation of the tendons can occur, but the most common tendon disorders involve degeneration of the tendon due to an inability to cope with the load that the tendon is placed under. What determines the amount of load that tendons can handle and whether this is exceeded? The human body is designed so that the size of tendons is just greater than the maximum force they are likely to need to endure. There is a good reason why they aren’t made a lot bigger than this. When a tendon is under close to its maximum force, it stretches slightly (without being damaged) and can store energy to recoil elastically a short time later. This mechanism of energy storage in tendons allows humans (and other animals) to run, jump and throw faster than would be possible if tendons were built to be much wider than they actually are. The disadvantage of having only a small amount of leeway in the size of most tendons is that if tendons develop some partial damage (degeneration) they can start to fail under normal circumstances (when they should only be stretching, not failing). Can damaged tendons heal? The good news is that tendons have a good ability to heal in adults. Tendons are mainly made up of fibres of a substance called collagen. The body heals most areas of damage with scar tissue, which is also made up of collagen. The only major difference between undamaged tendon and scar tissue, is that in normal tendon the collagen fibres are all arranged neatly in a vertical alignment to best withstand the force that the tendon will be placed under, whereas in scar tissue the collagen fibres are randomly arranged in many directions. This means that for the same width of tissue, normal tendon can withstand a much greater vertical pulling force than scar tissue. So how should I treat tendonitis? (1) Reduce the load on the tendon BELOW the threshold of further damage? (2) Exercise the tendon to strength it below this threshold, rather than totally rest. (3) Consider other factors which may improve the rate of tendon healing (e.g. Aprotinin injections). If you have an Achilles tendon injury or Patellar tendon injury please download the linked Acrobat .pdf forms to assess your current pain levels: VISA Achilles form (.pdf) and VISA patellar tendon form. Useful links on the Web: Structure of normal tendons (scientific paper) Achilles tendon injuries (chapter from Clinical Sports Medicine - Brukner and Khan) Medline references for treatment of tennis elbow My own reviews of groin pain: |