Tendonitis: How Resting Will Make It Worse



Let’s get started on this weeks topic…. Tendonitis.

I’ve had a few cases of tendonitis this past month and they’ve got three things in common…

There’s a weakness in the muscle or one of the surrounding muscles, lots of tension and overuse.

All of these affect each other and one will cause the other to get worse. A weak muscle puts a lot of pressure on the surrounding muscles. This then causes tension to increase in these muscles. As a result, other muscles have to work harder and this overuse causes tension.

So What is Tendonitis?

It might sound very complex but it’s pretty simple….

Tendons attach all the muscles in our body to our bones and without them, muscles could not do their job. Tendonitis is an overuse injury, making it chronic in nature. Often times my clients say they feel it building up slowly overtime.

The pain that’s felt is often because the tendon becomes irritated and inflamed. This irritation becomes worse and eventually it hurts everytime that muscle and tendon is in use.

So Why Does This Happen?

It often happens as a result of on a biomechanical imbalance, causing the muscles to do too much or do a different job than what it was designed for. This imbalance can also cause the tendons to do work in a different path, causing irritation or inflammation.

It can also happen if the muscle is stronger than the tendon itself. This puts the tendon under a lot of pressure, as it cannot support the action that the muscle is performing.

I’ve seen this with one of my patients. At first it started as an ache and he tried to push through it and sadly it became so damaged that the tendon snapped away from the bone.

How Do You Treat it?

Tendons work under the eccentric contraction (lengthening) of the muscle. This is why most of the time it’s caused by repeated bouts of twisting or turning. Taking time out of certain activities like golf, fishing or tennis will help the tendon ‘calm’.

Tendonitis is a warm injury so icing while resting is essential. This allows the tendon to cool and reduces the pain you’re feeling.

Physical therapy can also help to remove any swelling in the tendon and release the tension in the surrounding muscles, with plenty of hands on treatment including instrument or tool assisted soft tissue mobilization (also known as “scaping”), joint mobilization, cupping or trigger point dry needling.

This allows the muscles and tendons to go back into the position that they were designed to be in. Stretching can also be a vital part of recovery by relieving the pressure on the tendon.

Strengthening the surrounding muscles and the tendon itself then becomes necessary. This strengthening is done by resisting the opposite action.

For example, the bicep bends the elbow; so to strengthen the tendon you must resist strengthening of the elbow.

This ‘training’ can last up to 4 weeks. But don’t worry, this means that the pain has less chance of coming back.

The worst thing you can do…. And I’ve seen it countless times, it so just rest and ice, then go back to the original activity. Do not do this. It will only end up making things worse in the long run.

Strengthening is vital!

I hope this has helped if you or someone you know things that they may have tendonitis.

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Nick Hunter, PT, DPT

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