Lower limb tendinopathy…. What not to do

Tendinopathies are very frustrating for patients to manage. A tendinopathy is the result of a tendon being loaded above its capacity (this can be from a lighter load over a sustained period or a short period of intense load). Initially it responds by swelling and becoming painful. If left unchecked it can become chronic and degenerative/weakened. Weakened tendons are more likely to tear and even rupture.

It is important to remember that tendon structure adapts to load change (if you stop using it, it will adapt and become weaker). The good news is that you can use this adaption to build resilience in your tendon and improve its functional capacity…… It just takes education, discipline and patience. Our physiotherapists understand this and will help you through the process.

What not to do

1. Rest completely. Rest will decrease the ability of the tendon to take load in the future
2. Have only passive treatment. You may get some short term relief from things like ultrasound/acupuncture but you need to load the tendon to make it more resilient.
3. Have injection therapies. They are shown not to be effective in studies.
4. Ignore the pain. Manage the load on your tendon! Pain is your body telling you that your current load is too much.
5. Stretch your tendon. Stretching the tendon can put a compressive load on the tendon that will overload it further. Massage the muscle instead and this can release the load on the tendon.
6. Massage the tendon. Again this compressive force locally can be detrimental.
7. Take short cuts with rehab. It is not a quick fix and it will take time to load and increase the resilience and function of your tendon.