Tendon pain Archives - Peninsula Osteopathy

October 5, 2023

By Mitch Mee Acute, Chronic, Elbow, Hips, Knee, Overuse, Tendon pain

Overcoming Overuse Injuries: A Guide to Prevention and Healing

In today’s fast-paced world, many of us lead active lives and engage in various physical activities. While being active provides numerous health benefits, it can also lead to overuse injuries. Overuse injuries occur when repetitive movements put excessive stress on specific parts of the body, resulting in pain and discomfort. Fortunately, our team at Peninsula Osteopathy & Allied Health put together some information on common causes and types of overuse injuries, how we can assist you to address these injuries and how you can help yourself!

Overuse injuries typically develop gradually and can affect anyone engaged in repetitive activities. Some common causes include:

Repetitive Motion: Repeatedly performing the same movements, such as running, jumping, or throwing, can strain the involved muscles, tendons, and joints.
Training Errors: Increasing exercise intensity, duration, or frequency too rapidly without allowing adequate time for recovery can overload the body, leading to injuries.
Poor Technique: Incorrect posture, improper form, or flawed biomechanics during physical activities can place undue stress on certain body parts, making them susceptible to overuse injuries.
Inadequate Rest and Recovery: Failing to incorporate rest days into your exercise routine can prevent your body from healing and repairing itself, increasing the risk of overuse injuries.

Common types of overuse injuries include:

Tennis/Golfer’s Elbow: Characterised by pain and inflammation/irritation in the tendons of the elbow, typically caused by repetitive wrist and forearm movements.
Runner’s Knee (Patellofemoral Pain Syndrome): A common knee condition resulting from excessive stress on the kneecap, causing pain during running or activities involving knee bending.
Shin Splints: Pain along the shinbone (tibia) caused by inflammation of the muscles, tendons, and bone tissue due to repetitive impact activities like running or jumping.
Achilles Tendinitis: An inflammation of the Achilles tendon, the large tendon at the back of the ankle, caused by repetitive strain or overuse.

Here at POAH, our osteopaths can play crucial roles in the diagnosis, treatment, and rehabilitation of overuse injuries. We are able to assist you with:

Accurate Diagnosis: We will conduct a thorough assessment to identify the specific cause of your overuse injury and determine the best course of treatment.
Individualised Treatment Plans: Based on your diagnosis, we will develop personalised treatment plans incorporating a range of techniques such as manual therapy, exercise prescription, stretching, and strengthening exercises.
Rehabilitation and Exercise Programs: We can guide you through progressive exercise programs aimed at restoring strength, flexibility, and function, while ensuring you regain optimal movement patterns.
Education and Prevention: Finally we can provide valuable guidance on proper technique, training modifications, and injury prevention strategies to reduce the likelihood of recurring overuse injuries.

While professional guidance is crucial, self-management also plays an important role in the recovery process. Here are some practical tips for managing overuse injuries:

Rest and Recovery: Allow your body sufficient time to rest and heal. Modify or temporarily halt activities that exacerbate your symptoms.
Pain Management: Ice and heat pack strategies can be effective pain relievers, often personal preference dictates whether hot or cold will benefit you more. Over-the-counter pain relievers or anti-inflammatory medications, used under medical guidance, can also help manage pain and inflammation. Please ensure you consult with your medical practitioner to determine what is the most appropriate for you.
Proper Technique and Form: Pay attention to your body mechanics and ensure you are using correct posture and technique during activities to reduce unnecessary strain on vulnerable areas.
Gradual Return to Activity: When your symptoms improve, gradually reintroduce activities, starting with low impact and gradually increasing intensity and duration.
Cross-training: Engage in alternative activities that work different muscle groups, reducing the repetitive strain on the injured area while maintaining overall fitness.
Stretching and Strengthening: Perform specific stretches and exercises recommended by our team to enhance flexibility and strengthen the affected area.

Overuse injuries may try to slow you down, but they won’t stop you! Your passion for the activities you love is worth preserving, and your well-being matters. That’s why the team at Peninsula Osteopathy & Allied Health is here, ready to be your allies in recovery and vitality.

Don’t let pain hold you back. With our expert care and your commitment to self-management, we’ll help you reclaim your active, pain-free lifestyle. Remember, the sooner you act, the faster you’ll thrive. Reach out to us today and let’s conquer those overuse injuries together. Your journey to a healthier, happier you starts now!

April 8, 2022

By Gemma Percy Chronic, Elbow, Injury, Overuse, Running, Sporting, Tendon pain

Overuse injury – The what, why’s and how’s answered.

What is an overuse injury?

An overuse injury, sometimes referred to as a chronic injury, refers to an injury that is associated with repeated stress or micro-trauma over time. Unlike an acute injury, such as an ankle sprain, over use injuries typically have no specific incident that caused the pain, rather it will typically gradually worsen with activity with a steady increase in pain. Common overuse injuries include tendinopathies, bursitis, stress fractures/bone stress and shin splints.

It is common to see overuse injuries in the athletic population however they can be seen in all population groups – whether your 10 years old starting netball for the first time, 37 and trying to return to a loved past time or 71 and wanting to start walking more, you must know your limits. Overuse injuries are often related to activities that require repetitive stimulus such as long distance running, swimming, occupation demands such as typing and computer mouse use.

What causes an overuse injury?

An overuse injury will occur for a number of reasons and is related to a break down of tissue structure when the load input exceeds the tolerable level for that specific tissue. Common causes of overuse injuries can include:
• A sudden and/or significant increased load; including but not limited to increased intensity of training, increased hours of training, increased frequency of training
• A change to training conditions; including but not limited to addition of hills, change of footwear, change of training surface
• Return to activity after period of inactivity – e.g. start of sporting season return to walking after surgery etc.
• Inadequate rest periods – leads to increased muscle fatigue and therefore increase load/reliance on tendons, bones and other structures.

How to prevent an overuse injury?

Given that the biggest and arguably only cause of an overuse injury is overload it goes without saying that the best chance at preventing an overuse injury is to follow a progressive loading program and avoid going in too hard too soon.

When starting a new exercise routine or looking at increasing your current training regime it is crucial to have a graded and steady increase. This may look like short periods of work in combination with periods of rest when starting running/walking/swimming or other exercise routines. Ensuring you take regular rest days in the early stages of beginning an exercise routine to allow for adequate muscle recovery is another vital key in reducing your risk of overuse and injury.

If you are an avid exercise goer and looking to increase or alter your current regime following the guidelines of progressive overload will limit placing too much demand on your body systems too soon. Progressive overload can be applied by changes to duration/intensity, frequency, exercise technique/execution or external load – in any of these cases an incremental increase of no more than 10% is advised to reduce the risk of overload and injury.

In the case of overuse injuries in day to day life or with work place demands consideration may given to desk ergonomics and/or technique of repeated movements to attempt to reduce strain on specific body parts that may be at risk over overuse.

How to treat an overuse injury?

Unfortunately due to the slow progression and repeated micro trauma of overuse injuries it is often too late for preventative measures by time your pain develops. If you develop pain that you believe may be an overuse injury it is important to seek medical advice to ensure you receive advise specific to your injury and needs.

When visiting your healthcare provider (Osteopath or Myotherpaist etc.) you can expect your practitioner to assess your tolerance to specific loads and determine a management plan to get you back on your way to achieving your goals. Things that may be considered in your long-term management may include:

• Resting without or without the use of a brace or aid if severely intolerant to load.
• Reducing provocative loads and activity – this may look like a 50% decrease in kms walked/run, or reducing frequency of sessions in the gym
• Limiting spring like loads such as jumping that place a large load through injured areas
• Implementing a exercise/rehab regime specific to your goals.

It is important to note that in all cases of overuse injury LOADING with exercise is essential for long-term recovery and prevention of re-injury. An exercise regime tailored to you is likely to include the following:

• Isometric exercises – those that involve holding a sustained position for an allocated time frame e/g. wall sits/planks etc.
• Isotonic exercise – those that involve moving a body part through its range of motions with or without external forces/load
• Plyometric/return to play – If your goals require you to return to sports/high levels of exercise your program will progress to a sports specific return to play plan
that will involve explosive efforts

In all cases you can expect a program to progress through different stages in line with what you are hoping to achieve and usually takes between 6-12 months for adaptations to occur – Rest assured this does not mean your pain will persist for this period of time!

In conjunction with a loading program your practitioner will work with you to reduce and manage your pain. This may be done through the use of braces/taping, manual therapy (such as soft tissue massage), Ice, Dry needling and/or anti-inflammatory medications.

When indicated your practitioner will also work to find underlying bio-mechanical imbalances or deficiencies in surrounding areas and guide you with the steps required to address these also – This may include looking at your hip when dealing with an Achilles (lower leg) tendinopathies.

Please note that this advice is generalised and we encourage you to seek further advice if you think you may have an overuse injury – For more specific advise or to get started on your journey to recovery from an overuse injury book an appointment with one of our qualified practitioners today!
Book an appointment online here today!
Tennis Elbow – in the non-tennis playing individual!
Tame Your Achilles Tendon Pain!

December 23, 2021

By Gemma Percy Exercises, Running, Sporting, Tendon pain

Tame Your Achilles Tendon Pain!

With the warmer weather and a new year in sight it is likely many of you are experiencing a surge in motivation to get your body moving more – however it is important to bear in mind that doing too much too soon or too quickly can wreak havoc on the body if unprepared! In this article we will touch specifically on Achilles tendinopathies unravelling the who, what’s, how’s and why’s behind why your Achilles might be angry.

What is a tendon?

A tendon is a well-organised collagenous tissue designed to bear large loads and act as an imperfect spring as we move our body. Tendons are all over the body connecting our muscles to our bones and work to store and release energy to produce high and fast loads that allow us to walk, run and jump at max efforts!

Who gets Achilles tendinopathy?

Achilles tendinopathies hold no prisoners affecting nearly all population groups – young & old, walkers & runners and those playing multi directional sports. So what causes tendinopathies to develop? The largest risk factor for developing a tendinopathy is a sudden and unprepared change in load – for the Achilles this could include:

• Increased distance of walking/running
• Increased speed
• Introducing hills
• Change of footwear
• Change of surface
• Training for an event

This change in load causes the tendon to become overloaded resulting in a cascade of changes within the cell make up of the tendon resulting in inflammation and often pain.

Symptoms of Achilles tendinopathy:

Those with Achilles tendinopathy will often complain of localised pain over the Achilles insertion, pain that is worse with walking or hills, morning pain/stiffness. Typically pain associated with a tendinopathy will be worse before and after a session and tend to improve throughout the session itself.

How to manage Achilles tendinopathy?

So what to do if this is all sounding a little too familiar? It is a common misconception that when experiencing pain we should immediately stop all aggravating activities and rest – however when dealing with tendons this is not the case. Due to the nature of tendinopathies it is important that part of the treatment involves loading the tendon to improve its capacity to store and release energy through explosive movements.

Initially to reduce pain you may be required to partially de-load your tendon and stop explosive efforts that require large amounts of stretch & shorten through your muscles. This could include reducing the km’s you walk/run by 50% and resting from all jumping activities while working on slowly loading the Achilles tendon.

In the initial stages of your Achilles tendinopathy your health professional may use therapies such as:
• Manual therapy – soft tissue massage, joint mobility and stretching
• Myofascial dry needling
• Taping to offload the affected area
• Heel wedges or orthotics

Those with Achilles tendinopathy may also find it useful to:

• Limit prolonged standing
• Limit calf stretching
• Limit flat shoes/barefoot

Finally your health professional will work with you to develop a rehab program that will target strength of the Achilles tendon – this will likely include isometric exercises, which require you to hold a certain position for periods, isotonic exercises such as calf raises and in the later stage the introduction of specific hopping, jumping and explosive exercises to ensure a safe and pain free return to walking, running or sport!

For more specific and tailored advice be sure to chat to your Osteopath to work out a plan that works best for you and to address any barriers or fears you may have associated with your Achilles pain. Always consult your healthcare provider before commencing a new exercise program.

August 5, 2020

By Gemma Percy Elbow, Exercises, Sporting, Tendon pain, Uncategorised, Work Injury

Tennis Elbow – in the non-tennis playing individual!

What is tennis elbow?

Are you someone suffering from pain on the outside of your elbow and Dr Google is telling you that you have tennis elbow, despite never touching a tennis racquet in your life? Tennis elbow, otherwise known as lateral epicondylalgia, is an overuse injury affecting the outside of your elbow resulting in pain, tenderness and substantial limitations in functionality of the upper extremity.

Clinically tennis elbow presents as pain that is aggravated with repeated movements of the elbow or wrist, pain with lifting and decreased or painful grip strength.

Lateral epicondylalgia commonly affects those in office jobs, construction/repair, cleaners and healthcare workers and is associated with repetitive bending and straightening of the elbow joint for more than 1 hour per day.

In greater depth lateral epicondylalgia is both a load related and systemic based condition that ch

aracteristically has an acute inflammatory stage and a chronic degenerative stage. Lateral epicondylalgia affects the extensor carpi radialis brevis tendon and occurs when there is weakness and decreased capacity of the tendon to manage loads resulting in micro tearing within the tendon. This micro tearing further reduces the tendons capacity and elicits a pain response with in our body such that activities of daily living such as picking up a coffee cup can be sufficient enough to trigger pain.

Lateral epicondylalgia often goes hand in hand with a mild degree of shoulder girdle weakness. When using our arms for day to day activity we require a transfer of energy along the chain from shoulder to elbow to wrist – in tennis elbow a weakness in the shoulder leads to an increased demand on the elbow and wrist and hence an overload as discussed above.

The good news is that tennis elbow is generally self limiting meaning that within 6-12 weeks you are like

ly to experience significantly less pain, improved functionality and healing of the underlying tissues.

So how can treatment help?

Treatment of tennis elbow may involve soft tissue massage, joint mobilisation/articulation and mild or gentle stretching in combination with strengthening exercises to prevent reoccurrence. The goal of treatment is to reduce the duration of symptoms and associated disability. Treatment is thought to stimulate mechanoreceptors, which in return inhibits or blocks pain signals from nociceptors reaching the brain.

Your practitioner may also suggest a brace or assist you with taping techniques of the elbow to increase your function. Taping/bracing plays a role by placing tension at point on the muscle distally to irritated/damaged tendon site promoting healing of the damaged area.

In some cases injection of cortisone may be indicated however there is research to suggest that injection may lead to poorer long term outcomes in function and movement.

Getting started – What can I do from home?

The best thing you can do to help yourself is to rest from aggravating loads – this may include avoiding repeated wrist, forearm or elbow movements. It is important not to avoid all upper limb movement as this may further decrease the ability of your tendon to load! When completing movement or exercise it is important to take note of your pain levels – if what you are doing is increasing your pain rating by more than 1/10 it is advisable to stop that activity/exercise where feasible.

Caution should be taken with stretching, as overstretching may further increase tension/load on tendon and influence the pain response – when stretching the extensor muscle group you should complete this with your elbow bent at 90 degrees and stop if pain persists. The use of ice (cryotherapy) may be of benefit in reducing the inflammatory response and assist in reducing the acutely painful elbow.

Exercises that may be beneficial in reducing pain and improving the overall function are outline below:

1. Isometric wrist extension

• Start in a seated position with your forearm resting on a table and your palm facing down.• Place your other hand on the back of your affected hand.
• Attempt to lift your affected wrist up, whilst resisting the movement with your good hand (Ensure you keep your forearm in contact with the table.)
• Hold this position for 10 seconds
• Repeat 10 times, 3 times through with a 60 second rest between sets.

2. Scapular retraction

• Start in a standing position with your arms by your side and palms facing backwards.
• Gently push your hands backwards and feel a gentle squeeze between your shoulder blades (Ensure you keep your shoulders away from your ears)
• Hold this position for 2 seconds and slowly return to starting position
• Repeat 10 times, 3 times through with a 60 second rest between sets.

We encourage you to consult a health care practitioner if your pain persists or for more personal advice and advanced care of tennis elbow.

Drysdale Clinic

Portarlington Clinic

Pilates + Yoga

Category: Tendon pain