Tendinitis and Tendinosis/Tendinopathy Flashcards
What is the difference between tendinitis and tendinosis/tendinopathy
They both are from overloading the tendon but tendinosis/tendinopathy is also degeneration of the tendon and doesn’t cause inflammation unlike tendinitis
what is tendinitis
acute condition that can cause inflammation
What is the treatment for tendinitis
rest, NSAIDS, maybe steroids (total recovery is expected)
what is paratendinitis
inflammation of the parathion (external to tendon)
How do you treat paratendinitis
the same as tendinitis
What is tendinosis/tendinopathy
Chronic condition, that doesn’t cause any inflammation, overload and degeneration of tendon
what is the treatment for tendinosis/tendinopathy
rest (possibly), NSAIDS (even though there is no inflammation)
Are we more likely to see tendinosis or tendinitis
tendinosis
what has a longer recovery tendinosis or tendinitis
tendinosis
What is the pathology of tendinopathy
- No inflammatory cells
- Calcification and tenderness is possible (calcific tendinopathy)
- collagen fibers are disrupted and likely nonparallel arrangement
- fibroblastic degeneration
- neovascularization:
- apoptosis:
What are common areas to get tendionpathy
- achilles
- posterior tip
- patella
- rotator cuff
- biceps long head
- lateral humeral condyle
What happens to the tendon in tendinopathy
- Tendon gets thicker and is less stiff
- is very painful and produces less muscles force
What usually causes tendinopathy
overuse/overload on the tendon
What type of force to tendons not like
compresion
what tendon is prone to compression in the shoulder and can lead to rotator cuff pain
supraspinatus tendon
What modalities are commonly used to treat tedinopathy
- ice
- phono and iontophoresis
- ultrasound
- E-stim
- laser
Are modalities effective treatment for tendinopathy
no, it is unlikely that any modality is effective
What are general treatment approaches to tendinopathy
- NSAID
- rest or controlled rest from activity
- stretching
- soft tissue mobilization
- unloading/decrease load (orthotics)
- reloading (focusing on eccentrics)
What is the EdUReP model for tendinopathy
Educate
Unload
Reload
Prevent
What way is one way to unload a tendon
bracing or orthotics
What are ways we can reload the tendon
Eccentric exercise that gradually get loaded progressively, and within pain tolerance
Why would we want to reload the tendon
- activate tenocytes
- remove damaged fibers
- increase collagen synthesis
- remodel tendon fibers
How can we prevent tendinopathy reoccurrence
- having pt complete enter eccentric prgoram
- identify other impairments and develop interventino
- identify comorbidiites and consult a physician
- integrate tendon loading program for long term application
What does evidence support as good ways to treat tendinopathy
eccentrics or slow resistance training
How can we strengthen a tendon with tendinitis
- compressive vs tensile load
- emphasis on isometrics in shortened range
- dont go below neutral
- high load
- progress to isotonic ex and then to eccentric
what is an example of an eccentric exercise for achilles tendinopathy
- 3x15 reps, 2x day, 7 days/week for 12 weeks
- phased eccentrics
What are some newer approaches to tendinopathy
- nitric oxide patch
- sclerosis agents
- stem cell
- PRP
Is stretching a good treatment for teninopathy
common treatment but not evidence for it to prevent injury
