Understanding & treating Tendonitis/Tendinopathy & Tenosynovitis
Tendonitis/tendinopathy and tenosynovitis are common conditions that can cause pain, inflammation, and discomfort in various parts of the body. These conditions primarily affect the tendons, which are the thick, fibrous tissues that connect muscles to bones.
In this post, we explore these conditions in more detail, understanding their causes, symptoms, and treatment options.
1. Tendonitis/Tendinopathy
Tendonitis/Tendinopathy refers to chronic tendon degeneration caused by repetitive microtrauma or aging. The acute, reactive, phase of tendinopathy (previously called tendonitis) is when a degenerative tendon is overloaded and this stage can be characterised by localised pain and, sometimes, swelling. Tendinopathy is characterised by a failed healing response and changes in the tendon structure. The most common tendinopathies include Achilles tendinopathy, patellar tendinopathy, and tennis elbow.
Physiotherapy treatment for tendinopathy:
- Settling the acute/reactive phase with ice, appropriate loading +/- isometric exercises
- Eccentric exercises that gradually load and strengthen the affected tendons, promoting tissue adaptation and healing.
- Shockwave therapy, which delivers high-energy sound waves to stimulate blood flow and tissue repair.
- Application of heat or ice to manage symptoms and reduce pain and inflammation.
- Use of orthoses or protective braces to provide support and offload the affected tendons.
- Implementation of a comprehensive exercise program targeting the whole kinetic chain, addressing any muscle imbalances or biomechanical issues contributing to tendinopathy.
3. Tenosynovitis:
Tenosynovitis refers to inflammation of the synovial sheath surrounding tendons. It is often caused by repetitive motions, excessive strain, or underlying conditions such as rheumatoid arthritis or infection. Common areas affected by tenosynovitis include the wrist & the fingers (trigger finger).
Physiotherapy treatment for tenosynovitis:
- Immobilization of the affected area using splints or braces to allow rest and protect the inflamed sheath.
- Gentle range of motion exercises for maintaining joint mobility and preventing stiffness.
- Modalities such as ultrasound or laser therapy to promote healing and reduce inflammation.
- Education on ergonomic modifications to reduce strain on the affected tendons during daily activities.
- Manual therapy techniques to address any contributing factors such as joint restrictions or muscle imbalances.
- Gradual reintroduction of activities, focusing on proper technique and pacing to prevent relapses.
Tendinopathy/Tendonitis, and Tenosynovitis can significantly impact daily activities and quality of life. However, with timely diagnosis and appropriate physiotherapy interventions, individuals can experience significant improvements in symptoms and function. It is essential to consult with a qualified physiotherapist for an accurate assessment and personalised treatment plan that addresses the specific needs of each condition. Remember, early intervention and a comprehensive approach are key to successful rehabilitation.
