Tendon injuries - the what, why and how to prevent them!
Tendon injuries are a real pain, literally! They can happen to any of us, and are often the result of overloading the tendon tissue through too much repetitive or heavy exercise, and can also occur as a result of a sudden event or accident.
What is a tendon?
Tendons are the tissue that attach muscles to bones. They are made up of dense, fibrous connective tissue that transmits the mechanical force of muscle contractions. The tendon is attached via a musculo-tendinous junction to the muscle fibres at one end, and connects firmly to bone at its other end. Tendons are remarkably strong, having one of the highest tensile strengths found among soft tissues in our bodies.
Did you know that your Achilles tendon is the largest and strongest tendon in your body as it has to withstand the forces of body weight during standing, walking and running!
What’s the difference between tendon tears, tendinitis, and tendinopathy?
A tendon tear or rupture occurs as a result of an acute injury or event, causing tearing of the tendon tissue. Examples include rotator cuff tears due to a large sudden force on the shoulder e.g. heavy lifting, or Achilles tendon ruptures which can happen with explosive running or jumping. In both of these examples, there is often immediate pain, sometimes an audible popping noise, followed by weakness or loss of range of movement. These types of injuries will usually require orthopaedic review and in some cases surgery, and can take many months to heal.
Tendonitis is used to describe acute inflammation of the tendon. This can occur within the tendon tissue itself, or in the tendon sheath (paratendon - referred to as paratendonitis). Common symptoms include localised pain, swelling and warmth in the injured area . If managed effectively these injuries can recover within several weeks.
Tendinopathy is the most common form of tendon injury, and refers to changes in the tissue that occur over time due to repeated stress on the tendon, and can be more chronic in nature. Common symptoms include pain and thickening of the affected area, weakness and limited strength or function. With appropriate physiotherapy management these injuries can resolve within a few months.
How can these be prevented?
You may have heard us talk about “load management” when discussing injury prevention or rehab - the same rule applies with tendon injuries!
Load refers to the amount of stress being placed on our bodies tissues, and can be increased by volume, duration or intensity of your workouts. If we underload our tendons they become weak and the tissue quality declines, and if we overload our tendons there is a risk of tissue damage or injury. Ideally, we need to be staying in the sweet spot which involves consistency and progressive increases in training load, as well as adequate recovery time between workouts. This will ensure that our tendons are able to adapt to these specific stresses and get stronger as a result!