What is tendinitis? How Do We Fix It?

What is tendinitis? How Do We Fix It? 

Outline. 

•  What is a tendon? 
•  A Tendon is the dense connective tissue that attaches a muscle to a bone.  If you have ever cooked chicken tenderloins.  It is that annoying white piece that you have to cut off each piece.  

•  Qualities of a Tendon. 
•  Dense connective tissue that is designed to transmit force and energy through the body. 

•  Stiffer Tendons. 
•  Transmit more force quickly / power. 
•  Running, jumping, throwing, etc. 
•  Tend to be shorter
•  Potentially increase risk of muscle strains. 

•  Less Stiff Tendon
•  Lengthen easier, more pliable, but transmit less force
•  Think Yoga
•  Potentially less risk of muscle strain but also less capable of generating power. 

•  Why do we get Tendon Pain?
•  Microtrauma. 
•  Prolonged damage to a tendon caused by some form of stress leads to inflammation. 
•  Normal recovery the body repairs the damage cells and everything gets built back stronger. 
•  If because of repeated stress that your body can’t repair you may get increased inflammation that makes the area more sensitive. 
•  Nerve Sensitization 
•  With prolonged inflammation you may notice an irritability of the nerve, the skin may be more sensitive and you may be more reactive to normal types of pressure or stimulus. 

•  Tendinitis. 
•  Inflammation of the tendon that causes an increase in pain during palpation or use of the tendon. 
•  Tendinosis. 
•  A degeneration of the collagen may occur over time if the tendon repair process and inflammation is left unchecked. For more detailed information on the topic click here: https://rb.gy/a2l1mp

•  How do we fix it: 
•  Tissue Density Problems. 
•  If you tend to be a stiff / powerful person
•  Add in long slow holds like isometic exercises. 
•  See this example for a Push-Up isomtric exercise. https://www.youtube.com/watch?v=Y_yUHQ5ZRlE
•  Deciding how much and how often to load is the challenge. 
•  Need Enough stress to stimulate a change. 
•  Not so much that you can’t repair the change. 
•  If you tend to be a hypermobile person: 
•  Add in weightlifting and even progressing to plyometric type exercises that will promote tendon stiffness. 
•  Again the challenge is to load appropriately. 
•  See this example of a jump landing. 
• https://www.youtube.com/watch?v=DOr2NgH0UUA&t=37s
•  Nerve Sensitization. 
•  In this scenario we need to determine why the nerve is mad at you. There are 4 options. 
•  1. Local irritation of the tissue 
•  2. Irritation of the nerve somewhere along its path. 
•  3. An imbalance of the autonomic nervous system.
•  Fight / Flight (sympathetic) vs. Rest /Digest (Parasympathetic. 
•  4. Chronic pain leading to changes in the way your brain actually process the information from the nerves. 
•  ***It is beyond the scope of this paper to discuss how we sort which of these things is the primary culprit. We just want you to know they exist!
•  Tendinosis
•  We need to rebuild the collagen or connective tissue that makes up the tendon itself. 
•  Couple of ways we can do this. 
•  Local Dry Needling into the tendon. 
•  Triggers fibroblasts that cause regrowth. 
•  Progressive exercise loading.  
•  Similar to above on tendon length. Typically With Progressive Isometric and eccentric exercises. 
•  Blood Flow Restriction Training. 
•  BFR stimulates fibroblasts and a host of other repair molecules similar to high intensity exercise without the risks. 
•  Nutrition. 
•  You Must have the building blocks for collagen growth. We recommend two things. 
•  30 min pre-workout consume
•  Bone collagen needs to be present to rebuild the connective tissue. 
•  Our favorite is Great Lakes Bone Collagen. 
•  Amazon affiliate link (we appreciate the support)= https://amzn.to/3GK85S4 
•  Vitamin C. Is a precursor to the cell pathways to rebuild connective tissue. 
•  In depth information at the following link 
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723894/