Do you also have pain in your tendons? Let's talk about Tendinosis!

Have you ever felt a strange pain or stiffness in your elbow, knee , or shoulder? You may not have paid much attention to it. But if this pain persists, it could be a symptom of a condition called tendinosis . Don't worry, we'll talk about it in detail today.

What exactly is Tendinosis?

Simply put, tendinosis is a condition that affects the tendons in our body, gradually weakening and atrophying them. Now you may be wondering what these tendons are.

Think of tendons as strong cords. These are what connect our muscles to our bones. That's what allows us to move our limbs and perform various activities. These tendons are made up mainly of fine fibers called collagen fibers that come together and form bundles.

Tendinosis is when these collagen bundles gradually break down and begin to separate. This reduces the strength of the tendon. Over time, other types of cells come to fill in these broken areas. This changes the original composition of the tendon, making it heavier and stiffer. It's like an old rope with broken fibers, weakened, and unusable.

What are the symptoms of Tendinosis?

In this situation, you may feel things like:

• Pain with activity: When performing a task, especially when using the affected tendon, you may experience a burning pain . Some people describe it as “burning from the inside.”
• Stiffness and limited movement: The affected joint may feel stiff and difficult to move. There may also be a reduced range of motion, such as the inability to fully extend or bend the arm.
• Weakness: You may find it difficult to do things you used to do, which may mean you feel like you have less strength in your hands.
• Persistent pain: If the pain lasts for more than three months, that is also a symptom of this.

Most importantly, tendinosis does not usually cause swelling, redness, or warmth ( inflammation ).At first, you may not feel much pain. Some people think this is because the weakened tendon is putting extra weight on other tissues. However, later in the process, as the tendon begins to regenerate into a different tissue, it becomes more sensitive . This is because the tendon is developing new blood vessels and nerves.

Where does tendinosis most commonly occur?

Tendinosis can actually occur in any tendon, but it is most commonly seen in:

• In the knee: We call this (Patellar tendinosis) .
• Heel: This is called Achilles tendinosis .
• This is called posterior tibial tendinosis .
• Shoulder: Conditions such as (Supraspinatus tendinosis) or (Infraspinatus tendinosis) .
• Elbow: This is a problem that many people have. (Lateral elbow tendinosis) (also called tennis elbow) or (Medial elbow tendinosis) (also called golfer's elbow).
• Thumb/Wrist: A condition called (De Quervain's tendinosis) .

What are the causes of tendinosis?

Tendinosis occurs when a tendon is damaged and cannot heal properly. The main cause of this is repetitive strain injuries. Imagine doing the same type of work over and over again, loudly, or repeatedly. For example, you might be someone who uses a computer mouse all day, a painter, a carpenter, or an athlete. This causes micro-tears in the tendon. If you continue to do the same activity without stopping and giving the tendon the rest it needs to heal, you can develop tendinosis after a while.

There are other reasons that can affect this:

• A previous injury: Perhaps a sports injury has not fully healed, or the tendon may have been weakened by a previous surgery.
• Chemical damage: Some medications can also damage tendons. For example, antibiotics called fluoroquinolones , corticosteroids , and statins .
• Age-related degeneration: As you age, especially if you have used that tendon a lot throughout your life, it can weaken.
• Chronic inflammation: Tendinitis ( inflammation of the tendon) orIf conditions like synovitis (inflammation of the sheath around a tendon) persist for a long time, it can weaken the tendon and begin the process of degeneration.

Who is most likely to develop this condition?

People who engage in sports or jobs that involve repetitive motions every day are more likely to develop tendinosis. Athletes, blue-collar workers, and people who are very involved in a hobby are at higher risk of developing these (repetitive strain injuries) . When an injury occurs, it can be difficult for them to stop the activity and get enough rest for the tendon to heal properly. Because they want to get back to work quickly.

Some people may also be predisposed to this condition due to certain changes in body position. For example, if the top of a person's shoulder blade is tilted downward, the tendon can rub when the shoulder is pulled away from the body. This can cause chronic inflammation (tendinitis) and can progress to tendinosis. As the tendon wears down, small holes can form, and even large tears can occur without any injury.

What complications can occur if left untreated?

If you don't treat tendinosis, it can continue to grow, weaken the tendon, and eventually become completely dysfunctional. One way is when the tendon suddenly tears (tendon rupture) . Another way is when it can no longer do its job in the body, and the part that should be carrying the weight is transferred to another part of the body. This is like a domino effect . For example, if the posterior tibial tendon in your shin becomes dysfunctional, the arch of your foot can collapse and even change the way you walk.

How do doctors recognize this?

Tendinosis diagnosis begins with a physical exam and a health history. A doctor will ask about your symptoms, when they started, any recent changes in your daily routine, and any medications you take. They will also ask about your usual activities and any previous injuries. They will then take images of the tendon to see if there is evidence of tendinosis. Imaging tests can help distinguish between tendinitis and tendinosis .

How is Tendinosis treated?

With any tendonopathy , healing begins with rest . Tendinosis will not stop progressing until you stop the activities that put stress on your tendon. Depending on how severe the condition is, you may need to stop using the affected tendon for three to six months. The tendon heals very slowly.With rest, the cycle of injury and degeneration can be stopped. The primary goal of treatment is to help your tendon produce new collagen.

Your doctor may suggest things like:

• Painkillers: Although anti-inflammatory medications such as corticosteroids and NSAIDs (Nonsteroidal anti-inflammatory drugs) are commonly used to treat tendinitis , these medications can actually make tendinosis worse. Instead, your doctor may recommend acetaminophen (e.g. Panadol ® ), or topical painkillers (e.g. patches, creams, gels).
• Ice application: Ice application is a common home remedy for bone and muscle pain. It is also useful for tendinosis. Ice application constricts the blood vessels in the tendon. This helps to discourage the formation of new blood vessels and prevent tissue damage. Doctors recommend applying ice for 20 minutes several times a day.
• Massage: During the later stages of your recovery process, massage can help speed up healing by stimulating blood circulation. Your doctor will guide you on when and what types of massage to try. A new technique called deep friction massage may be particularly beneficial for tendinosis. It is thought to temporarily reduce pain and stimulate the production of new collagen in the tendon.
• Physical therapy: While activity modification is essential for recovery, physical therapy and a home exercise program are also important to prevent muscle atrophy . Your physical therapist will guide you through passive exercises to help rehabilitate your tendon and surrounding tissues. They will also prescribe exercises to do at home during your recovery.

These treatments are successful for many people. If your condition does not improve with standard treatments, your doctor may suggest additional treatments such as therapeutic injections, laser therapy, or surgery.

Do you need surgery for tendinosis?

Surgery is the last resort for tendinosis. Surgery is only considered if other treatments have failed. If the tendon is too damaged to heal on its own, you may need surgery. If a large amount of tissue has been damaged, it may no longer have the resources to rebuild collagen. In such cases, surgery can remove the abnormal tissue and make small incisions in healthy tissue to stimulate healing.

Is Tendinosis a permanent condition?

Some of the damage caused by tendinosis may be permanent. But that doesn't mean it will continue to affect you. With proper treatment, many people can stop the cycle of damage, relieve symptoms, and regain some of the tendon's previous strength and flexibility. However, your tendon may be more susceptible to future injury, so you should continue to take care of it.

How do we avoid tendinosis?

You can't prevent all causes of tendinosis. But there are things you can do to help protect yourself from repetitive strain injuries . For example, if your job involves repetitive motion, you can reduce stress by creating an ergonomic workstation . If you're an athlete, make sure you're warming up properly and using proper technique. If you're in pain, know when to stop.

The most important thing is to pay attention to pain without saying, "That's okay," when it comes.

Can someone become disabled due to tendinosis?

Tendinosis can be a temporary disability. It can reduce your strength and range of motion, and can cause pain with movement. This can make it difficult to do everyday activities. You may also need to stop using the affected tendon for a few months while it heals. If it prevents you from doing your job, you may be eligible for disability benefits, depending on the laws where you live or work.

What is the difference between Tendinosis, Tendinitis, and Tendinopathy?

These names sound a bit confusing, don't they? Let's see what they mean.

Tendinosis and tendinitis are two types of tendinopathy , which means they affect the tendons. Both can cause pain when the tendon is used, but for two reasons.

• Tendinitis is inflammation of your tendon. It can cause symptoms like swelling, redness, and warmth. This is the pain that comes immediately after an injury to your tendon. Think of it like the pain you feel when you suddenly lift something heavy and sprain your arm.
• Tendinosis is a more gradual, degenerative process in the tendon. Tendinosis is caused by repetitive strain injuries that do not heal properly.

If you have any type of chronic musculoskeletal pain, don’t delay in seeing a doctor. You may not be able to figure out exactly where you’re hurting or what kind of injury you have. While you may think “it will get better with time,” some conditions, like tendinosis, only get worse. By seeking medical attention early, getting the right diagnosis and treatment, you can minimize the damage and shorten your recovery time.

Finally, things to remember

Okay, so we've talked a lot about tendinosis. In short, it's a chronic condition that affects the tendons.

• Rest is essential: Stop the activity that causes pain and give the tendon time to heal.
• Correct diagnosis: If you experience pain, seek medical advice to find out exactly what it is.
• Physical therapy is important: Don't just sit around, do physical therapy and exercise as directed by your doctor.
• Prevention: If you continue to do the same type of work, take breaks in between, and be mindful of your working posture.

The most important thing is to listen to your body. If you feel pain, don't ignore it. With prompt treatment, you can recover quickly!