Understanding tendonitis is important. A tendon is collagenous tissue that attaches a muscle to a bone. Its function is to transmit the forces produced by the muscle to the bone in order to create movement at a joint in the body. As a result of overly repetitious or excessively strong forces, you may develop tears in the fibers of the tendon which results in tendonitis or inflammation of the tendon.
The first step in the rehab process is to control inflammation. You want to slow the blood flow to the injured area to allow absorption of blood released by injured tissue. The well-known “RICE” – rest, ice, compression and elevation – formula for treating localized inflammation has always been effective. Ice applied locally for 10 to 15 minutes over the injured area is most effective to control inflammation. For joints such as the knee, elbow and shoulder, an ice cup massage will probably be most effective as it covers uneven surfaces more thoroughly. Use ice up to seven to 10 days following the injury, especially if pain and soft tissue tenderness continue in the area of the injury. It is appropriate to use moist heat when stiffness becomes more of a problem and pain has significantly subsided.
Understanding Tendonitis – Treating This Condition
It is common for most people to stop treating their injuries at this point. However, the tendon has just begun to heal. At this time, appropriate force on the tendon is necessary. The following program identifies a daily outline to follow to treat tendonitis once the inflammation is under control.
1. Friction Massage – five minutes
2. Stretching the involved muscles and tendons – 5-10 minutes
3. Strengthening the involved muscles – 2-3 sets/10 reps of involved muscles
4. Ice cup massage – 10 minutes (until tenderness subsides)
Friction massage – Tendons heal through scar tissue formation. A very direct massage across the fibers of the tendon will help break down scar tissue and make it more elastic. Performing friction massage is only appropriate if you find the specific tender areas along the tendon that need to be “worked out.”
Stretching and Strengthening – Any injured tendon generally causes the attached muscle to become weak. Beginning with isometric strengthening (as tolerated) and progressing to Nautilus, free weight or rubber band resistance exercises allows a gradual progression to return normal strength.
Ice – Ice cup massage should continue until tenderness subsides. It will help you control any minor inflammation that may develop from performing the exercises.
With respect to these treatments, it is difficult for anyone to know whether they are massaging the right spot or stretching and strengthening the right muscles. The point, however, is that there is much more to rehabbing tendonitis than an occasional bag of ice. Most local sports medicine centers offer consultations at a minimal cost. They can evaluate your condition and teach you an appropriate home program. If you treat your condition early, a home program is often all that you need to resolve the condition.
Thomas Suspenski, PT, ATC
797 E Lancaster Ave. Suite 2
Please refer to patient education for other brief articles in our educational series. It is through these articles, in part, that we keep our patients (and others) informed of common injuries and conditions, their treatment and healthcare in general.