It is hard to identify if you have tendon pain or not. The following areas are the most common tendon problems. Tendon pain typically presents with a gradual onset of pain in one area. Often to start with the pain may be during an activity and then stops after. Typically, the pain is not enough to stop activity but can hinder progress. Often the pain gets worse and rest does not seem to help.
The following are the most common tendon pain areas:
- Achilles tendinopathy
- Lateral epicondylitis or Tennis Elbow
- Rotator cuff tendinopathy
- Proximal Hamstring tendinopathy
- Patellar tendinopathy
- Adductor tendinopathy
- Gluteal medius tendinopathy
PICTURE OF A TENDON
Causes of tendon pain is still widely discussed in the medical profession. The consensus is that the tendon which is the structure that attaches the muscle to the bone, either becomes over loaded (too much strain for the muscle-tendon to cope with) or compressed (this is also described as stretching the tendon)
An example of this situation could be that Mr X usually runs three times per week for 30minutes. He has decided to enter for a 10km race and has increased his distance but also started to do some speed work. The tendon/ muscle has enough strength to cope with the 30-minute runs but depending on how much change and load has increased this may cause the tendon to become irritated.
General guidelines for most tendons.
When the tendon is irritable the first thing to do is see if you can settle it down conservatively. This means try and calm down the symptoms. This may include ice massage, taping, and trying to reduce the compression through that tendon (see specific tendons to get a better idea of this).
Isometrics or static exercise have also been shown to help with pain relief, this means gently resist the movement that causes the pain without any actual movement. This needs to be low in pain scale.
The pain scale is a good guide to help you work out when to progress your exercises. The scale is between 1-10, 1 being very slight pain and 10 being the worst pain ever.
When doing tendon specific exercises, you must keep the pain below a 2/10 and they must be minimal problems after you finish the exercise. So, if you are still feeling pain 2 hours after the exercise it is too much too soon.
Firstly, the physio will work out if your tendon is irritable or stable and then prescribe specific exercises to gradually load the muscle/tendon which in return also helps to reduce the pain.