It’s NOT Tendinitis!

Tendinitis is the most misdiagnosed condition of the human body!  What’s worse?  What you’re trying to do to fix your tendinitis is actually making you worse!

Tendinitis (Yes, I am spelling it right. I’m not sure why the spelling of tendon gets changed when used in this context) is characterized as an INFLAMMATORY condition of a tendon.  Rest, ice, and NSAIDS (anti-inflammatory medicine) are prescribed for treatment.  Cortisone injections are also frequently used.  Typically, tendinitis gets WORSE with activity.  Most people suffering with true tendinitis recover within a few weeks.

Tendinosis is probably a term you haven’t heard before.  Tendinosis is a DEGENERATIVE condition of the tendon which produces similar symptoms to tendinitis.  Treatment of tendinosis includes manual therapy for degenerative tissue removal and eccentric exercise to strengthen and repair the damaged tendon.  Symptoms will usually go AWAY with activity. While you may not have heard of tendinosis, tendinosis is FAR more common than its counterpart tendinitis!

I wish I could say that this is a new discovery, but we have known about tendinosis since the 1940’s!  Most of the research shows that almost ALL tendinitis cases are actually degenerative – meaning its tendinosis!

Unfortunately, this also means that the drugs, ice, rest, and cortisone injections you have been using to get better is actually making you worse!  You see rest, ice, and NSAIDS all aim to prevent inflammation and restricts blood flow to the painful area to heal you.  This accelerates the degenerative process.

Since we know that “tendinitis” is degenerative, this leads to the worsening of the condition!  This is why you have been struggling with your pain for longer than just a few weeks!

If you have been struggling to fix your “tendinitis” you need to get a better diagnosis.  You deserve better answers. You deserve a better solution!

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If you live in the Cedar Rapids/Iowa City area, the experts at Thrive Spine and Sport are among the nation’s best in treating chronic muscle, nerve, and joint pain.  If you are struggling with tendinitis and looking for an expert opinion on what can be done to get you better, call us today at 319-423-0925!

 
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So You Got A Cortisone Shot!….Now What?

So you got a cortisone shot.  Now what?

At least that’s the question you should ask yourself.  You see, cortisone works great at eliminating inflammation – that’s the point of the injection – but inflammation is just the result of an underlying problem.  Cortisone does nothing to fix that!  The result, as some of you may know, is having to go back multiple times for more the cortisone just to get relief.

What you may not be hearing is that while cortisone may be of benefit in pain relief in the short term, studies are now showing that patients have a worse clinical outcome when compared to patients that did absolutely nothing for their pain and injury over the course of a year.  That should be startling information for those out there that have had a cortisone injection.

If you would like to see more on this information click here.

If you are someone who is debating getting a cortisone injection, or have already had one or several, there are some very important questions that you should answer.

The most important thing being – “What is your diagnosis?”  This should be a tissue-specific diagnosis!  Tennis elbow, plantar fasciitis, and tendonitis are NOT good enough!

The next question should be, “What are you trying to accomplish by getting the injection?”  Are you looking for pain relief, or are you looking for a permanent fix?”

If you have been diagnosed with tendinitis, this may seem like a simple solution, but being that a LARGE majority of tendinitis cases are NOT inflammatory and instead degenerative, cortisone will actually make this worse, as referenced here.

This brings us back to our original question – “What is your tissue-specific diagnosis?”

If you are debating another shot, “How long do you think this one will last?

If it’s your first, the average cortisone injection will provide 6-12 week’s worth of relief.  Some are lucky enough to get more relief than that.  People who already have had one, should expect similar results as before or less.

The last question to ask yourself should be, “What do you do after this shot wears off?”

If there was a tissue-specific diagnosis, there should already be a plan in place.  If there was no plan in place it’s time to get one!  You deserve better answers, you deserve better solutions!

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At Thrive Spine and Sport, we answer your first question!  Your body does not care what technique or treatment the provider is trained in.  It simply cares, what it needs to fix the problem!  If what your body needs is not a treatment we perform, we will refer you to where you need to be.

Thrive Spine and Sport specializes in the diagnosis and treatment of overuse and sport injuries, specifically the diagnosis and treatment of adhesion.  Adhesion is one of the most common, most misdiagnosed condition in the body causing pain, inflammation, and restricted range of motion.  Most of our patients have tried numerous providers before finding relief in our office.  If you or someone you know is currently struggling with pain, we invite you to call our office to get answers to your problem today at 319-423-0925!

Is It Tendinitis?

Does this sound familiar?

You develop pain, and it’s getting worse. You pull out your computer and search for what’s wrong. The search reveals “tendinitis.”

Looking at the treatment options, you decide to take a couple weeks off, ice twice a day, stretch as often as you can and take pain relievers when needed.

Things are going great, the pain has disappeared and you decide to get back to regular activity. You start your warm up. You begin to play or run, then uh-oh, the pain is back.

It hasn’t left. Now what do you do? Cortisone shot? Surgery?

Why did the pain return? The answer is simple. The diagnosis and treatment were wrong.

What we are finding now is that most cases of tendinitis are misdiagnosed and are actually tendinosis. While tendinitis is believed to be an inflammatory process, tendinosis is a degenerative one.

With return of activity and lack of proper recovery, we often see overuse of muscles and joints commonly used in that activity. With overuse, tendons and muscles become weak and degenerate. Once the muscles and structures are weak, adhesion will form to try to stabilize the area. This also alters joint motion and leads to further weakness and pain. If left untreated, this can lead to torn muscles, tendons and ligaments. Rest, ice and stretching do nothing to repair damage to injured soft tissue.

Overuse Cycle

Treatment of tendinosis takes a different approach. Try these four steps:

Manual therapy. Adhesion is the most common result of overuse. To remove adhesion, you need therapy from someone certified to treat the condition.

Eccentric exercise. When a tendon or ligament is degenerated, rest will not fix it. It needs to be regenerated and strengthened. Eccentric exercise does this by helping improve blood flow into the origin and insertion points of muscles where degeneration is common.

Load Management.  I hate the word “rest” when treating injuries, because in most cases it gives you false hope – that something is actually being fixed – when in reality it isn’t.  In tendinosis cases, rest helps the damaged soft tissue recover from treatment faster and reduces the risk of more severe injury. 97% of all soft tissue (muscle, ligament, tendon) tears happen in degenerated tissue.  This is tendinosis!

Get a brace. Using a brace reduces stress on the injured area and allows treatment to be more effective and can help speed up recovery time.

Recovery time depends on how long symptoms have been present and how much damage has been done to the soft tissue.

At Thrive Spine and Sport, we specialize in the diagnosis and treatment of adhesion, a primary cause of tendinosis and tendinitis.  If you or someone you know has been struggling to find relief from “tendinitis” it’s time to find out what’s really wrong!  You deserve real solutions to your problem.  Fill out the appointment request on this page or call our office at 319-423-0925 today!

Thanks for reading!

Is It Tendinitis?

Tendinitis and tendinosis. One you’ve probably heard before.  The other, probably not. While they both sound the same, in reality they are worlds apart.

Tendinitis is, by definition, inflammation of a tendon.  Tendinosis on the other hand is defined as chronic tendinitis and implies chronic tendon degeneration without the presence of inflammation. Basically, one is short-term with inflammation, the other long-term, without inflammation, though both are caused typically by overuse.

soccerTendinitis, the most popular diagnosis of the two, usually presents with swelling and tenderness at the sight of pain, often accompanied by stiffness, and less often by weakness. Tendinosis presents most often with stiffness, tenderness to the touch, and weakness–almost identical to tendinitis. Recovery of tendinitis lasts anywhere from days to six weeks, a relatively “quick fix.” Tendinosis recovery can last a few short weeks to a couple months or more depending on the level of degeneration. If left untreated, tendinosis often leads to “tear” injuries.

While both conditions are classically treated with conservative measures, the difference in care is absolutely critical to resolution of the problem. Conservative management stems around rest and anti-inflammatory medication for tendinitis, while conservative management of tendinosis aims to restore tendon regrowth and strength through manual therapy and eccentric exercise.

Both, occur most often in the Achilles tendon (ankle), patellar tendon (knee), proximal hamstring (high hamstring), common extensor tendon (elbow), and the supraspinatus tendon (shoulder).

With both of these problems being so relatively close, while treatment is vastly different, proper diagnosis is vital to the recovery process! So which one do you have? Let’s go to the research.

While tendinitis is the wildly over-popular diagnosis among general practitioners, it may not be the case. Most research coming out on this topic is now showing that at a cellular level, once believed tendinitis actually is, in fact, tendinosis.

According to Almekinders and Temple, “Most currently practicing general practitioners were taught, and many still believe, that patients who present with overuse tendinitis have a largely inflammatory condition and will benefit from anti-inflammatory medication. Unfortunately this dogma is deeply entrenched. Ten of 11 readily available sports medicine texts specifically recommend non-steroidal anti-inflammatory drugs despite the lack of clinical evidence.”

In light of this, chances are that if you have been diagnosed with tendinitis the diagnosis was incorrect. Furthermore, traditional, conservative treatment, of such, with the use of anti-inflammatories, corticosteroid injections, and/or pain medication may have left you worse off long term even though pain may have dissipated short term (but this conversation is for a different time). These methods were designed to eliminate inflammation, not regrow tendon. As mentioned above, treatment of tendinosis should be aimed at restoring tendon function and strength through manual therapy and eccentric exercise. Drugs will not help! Treatment should also include load management when deemed necessary.

With all this said, while we cannot assume a diagnosis was incorrect, lingering, worsening, or reoccurrence of pain would suggest that it may in fact be tendinosis. It is recommended that treatment plans geared toward tendinitis, in these cases, be reevaluated.

Tendinitis is one of the most commonly diagnosed injuries and all too many struggle to find relief. With the proper diagnosis and treatment plan, it doesn’t have to be that way!

At Thrive Spine and Sport, we specialize in the diagnosis and treatment of musculoskeletal injuries, including tendinitis and tendinosis.  Most patients have seen many different providers before finding relief in our office.  Fill out the appointment request on this page or call our office at 319-423-0925 to set up an appointment today!

Thanks for reading!