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Tendonitis can be successfully treated but it is important to note that the treatment protocol for tendonitis is unique and different than treating other acute injuries. The wrong treatment can exacerbate the condition increasing the time for recovery and getting back to sport.
Tendonitis can affect many body segments. Although the body segments may differ, the structural damage and healing process are the same. Understanding the basic structure and function of a tendon will give the athlete a better understanding of why the treatment protocol for tendonitis is different than other types of acute injuries.
What is the structure and function of a tendon? The purpose of a tendon is to connect muscle to bone. While the specific structure of a tendon may vary from tendon to tendon, the components are the same.
A tendon is primarily made up of collagen fibers, water, and ground substance. It is the components in the ground substance that give the tendon its viscoelastic properties ability to stretch and return to its original shape. When the muscle attached to the tendon contracts, the tendon straightens out and becomes tighter.
Some tendons are wrapped in synovial sheaths achilles and biceps tendons. In tendons where a sheath is present, the blood supply for the tendon comes primarily from the synovial sheath.
The synovial sheath also contains a very small amount of fluid to help reduce friction between the tendon and sheath while the tendon elongates.
As with muscle tissue, a tendon has a structural breaking point. Initially, when stress is applied to the tendon, the tendon will elongate. If the force continues beyond what the tensile strength of the tendon can handle, the tendon will eventually rupture.
What are the classifications of tendonitis? There are six classifications of tendonitis ranging from mild to severe. The athlete may also have pain in the affected region during everyday activities and not just during athletic performance. Repetitive loading of a tendon can breakdown otherwise normal tissue resulting in pain, swelling, and decreased functional ability of the associated joint.
Common causes of tendonitis include the following: The initial response of the tendon is inflammation.
Initially, the tendon becomes painful to the touch and begins to weaken. If the tendon is continuously overloaded, the tissue begins to break down. A number of structural changes can occur during this process including thickening of the synovial sheath surrounding the tendon, areas of abnormal tissue known as fibrosis are laid down within the tendon, thickening of connective tissue, and adhesions scar tissue laid down in and around the tendon.
The longer the condition goes untreated, the more structural changes occur. How to treat tendonitis? This step cannot be overemphasized because even if you treat the tendonitis, the condition will return if the cause has not been identified and dealt with.
Identifying the possible causes of tendonitis begins with a detailed history of the athlete specifically looking at specific load increases.
For example, in a softball pitcher suffering from bicipital tendonitis in her throwing shoulder, one would specifically look at the number of pitches thrown, the types of pitches thrown, the distances of pitches thrown, and the intensity of pitches thrown.
If there was an identifiable jump in the number, type, distance, or intensity of pitches thrown that triggered the tendonitis, then the therapist can work with the coach to reduce the workout to one in which the athlete can compete safely and without damage to her tendon.
In order to ensure that the tendonitis does not return, the causative factors must be identified and changed prior to the athlete returning to sport. How to treat tendonitis The initial phase in how to treat tendonitis is to get the inflammation under control.Dr.
Answorth A. Allen, MD, is an attending orthopedic surgeon at Hospital for Special Surgery, specializing in shoulder, knee, and elbow surgery, and an associate professor of clinical orthopedic surgery at Weill Cornell Medical College in New York City.
Dr. Allen is a team physician for the New York Knicks basketball team and a former team physician for the New York Mets.
Quarterback of the Washington Redskins, Robert Griffin III, had undergone ACL surgery to repair the anterior cruciate ligament yesterday morning () as well as repair a lateral collateral ligament in his right knee. An anterior cruciate ligament (ACL) tear is an injury to the ligament in your knee that keeps your shinbone from sliding forward.
The ACL stabilizes your knee, so tearing it either partially or. The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee.
In general, the incidence of ACL injury is higher in people who participate in high-risk sports, such as basketball, football, skiing, and soccer. An anterior cruciate ligament (ACL) tear is an injury to the ligament in your knee that keeps your shinbone from sliding forward.
The ACL stabilizes your knee, so tearing it either partially or. Medial ligament injuries at the elbow are the most common injuries in pitchers. This is damage to the ligament on the inside of the elbow, caused by repeated stress.