Tendonitis – Physio Guide to Treatment

physiotherapy london tendonitis wrist pain Physiotherapy in London

You’ve found our comprehensive guide to tendonitis! In this guide, we will take you through the differences between tendinopathy and tendonitis, shedding light on how these conditions affect your body. 

Our expert physiotherapists at One Body London are here to explain how physio can effectively treat tendonitis, using a range of treatments including targeted exercises and shockwave therapy. We’ll also guide you on how to book an appointment with us using private health insurance. 

Whether you’re dealing with persistent pain or wondering if your tendinopathy is something else entirely, this guide provides the knowledge and support you need to recover. Let’s get started!

Understanding Tendonitis

First, it’s important to note that tendonitis and tendinopathy are not interchangeable terms, as they refer to different aspects of tendon conditions. Confusingly, they often present with the same symptoms:

  • Chronic pain and tenderness that worsens with movement.
  • Stiffness and reduced range of motion.
  • Weakness, especially when you’re exercising.

Let’s define each condition to better understand their differences.

What is Tendonitis?

Tendonitis (also spelt tendinitis) is the inflammation of a tendon, the fibrous tissue connecting your muscles to your bones. This condition occurs when a tendon becomes irritated due to overuse or injury. It can lead to pain, swelling, and reduced function in the affected area.

Here are some of the most common types of tendonitis we treat at One Body:

  • Achilles Tendonitis
  • Wrist Tendonitis
  • Thumb Tendonitis (De Quervain’s Tenosynovitis)
  • Rotator Cuff Tendonitis
  • Patellar Tendonitis (Jumper’s Knee)
  • Tennis Elbow (Lateral Epicondylitis)
  • Golfer’s Elbow (Medial Epicondylitis)

What is Tendinopathy?

While tendonitis is the inflammation of a specific tendon, tendinopathy is a broader term that refers to chronic tendon damage. We can characterise tendinopathy as the degeneration of collagen fibres within the tendon. This condition results from repetitive stress or overuse, leading to pain, stiffness, and reduced function without significant inflammation.

You can think of tendinitis as an acute condition making a specific tendon inflamed, while tendinopathy is more of a chronic condition that can change the tendon structure.

If you are unsure which condition you have, a physiotherapist can help with an assessment and diagnosis (more on this below).

patellar tendonitis jumpers knee diagram Physiotherapy in London

What is Patellar Tendinopathy?

Patellar tendinopathy, also known as jumper’s knee, is a condition where the patellar tendon connecting the kneecap to the shinbone deteriorates due to repetitive stress. This is just one type of tendinopathy, characterised by chronic pain and reduced knee function.

Just like tendonitis, there are many types of tendinopathy. Confusingly, some have the same common name as tendonitis despite being chronic structural changes rather than acute inflammation.

  • Achilles Tendinopathy
  • Rotator Cuff Tendinopathy
  • Tennis Elbow (Lateral Epicondylopathy)
  • Golfer’s Elbow (Medial Epicondylopathy)
  • Gluteal Tendinopathy
  • Posterior Tibial Tendinopathy
  • Peroneal Tendinopathy

Whether you have a form of tendinopathy or a case of tendonitis, the good news is that physio can help!

How Physiotherapists Can Help

Physiotherapists play a crucial role in diagnosing and managing tendonitis and tendinopathy. Even if you initially go to your doctor for help – on the NHS or privately – physiotherapy is often the recommended course of action. In fact, if you think you have tendonitis or tendinopathy, you can go straight to a physio clinic!

When you visit a physiotherapist, the first step is a thorough assessment to understand the extent and stage of your condition. This involves a detailed examination of your symptoms, medical history, and physical activity levels. By evaluating your range of motion, strength, and functional abilities, we can accurately diagnose whether you have tendonitis or tendinopathy and determine the severity.

Next, we’ll create a plan of action.

Education is a vital component of physiotherapy. Physiotherapists provide you with essential information on how to properly rest and protect the tendon to prevent further damage. We will show you how to modify your activities to reduce strain on the tendon and guide you on how to maintain overall fitness without aggravating your condition. 

The ultimate goal of physiotherapy is to restore your mobility and function so you can live life freely and without pain. Learn more about this in our Guide to Physiotherapy.

Tendinopathy Physiotherapists

Choosing a physiotherapist with the right qualifications and experience in musculoskeletal physiotherapy is the first step you should take. 

Experienced physiotherapists can create a personalised treatment plan that addresses your specific needs and goals. We also offer ongoing support and adjustments to your treatment plan as you progress, ensuring your recovery goes smoothly.

Any clinic offering physio treatments for tendinitis or tendinopathy should be upfront and clear about the qualifications and experience of their therapists!

Physio Treatments for Tendinopathy

Getting the right treatment for tendonitis and tendinopathy starts with resting the affected tendon properly. We can’t emphasise enough how rest is key to helping the tendon heal and avoiding further damage! 

It’s important to follow your physiotherapist’s advice on how to adjust your activities and take breaks. We will show you how to balance rest with gentle movements to keep your flexibility and prevent stiffness. By sticking to their guidelines, you give your tendon the best chance to heal and get ready for the next steps in your treatment.

In addition to rest, your physiotherapist will help you create a treatment plan that involves restorative exercises. We may also recommend treatments like shockwave therapy. Here’s what you need to know about the various treatments available.

Eccentric Exercises

We’ll use a range of exercises to treat your tendon condition – your treatment plan is adjusted for the specific location of the tendon and the severity of the injury. For tendonitis, eccentric exercises are an effective way to treat the condition and encourage recovery.

Eccentric exercises follow three basic principles:

  1. Stretching the tendon – if we can increase the resting length of the tendon, it will be under less strain when it is used.
  2. Increasing the load – by slowly increasing the load (e.g. progressively heavier weights to exercise with) we can increase the strength of the tendon.
  3. More speed – your tendons contract when they are used. By practising faster contractions, we can strengthen them.

One example that we may recommend for achilles tendonitis is the heel drop. Standing on a step with your heels hanging off the side, you lift up onto your toes and slowly drop back down – this stretches the tendons and calf muscles.

Other eccentric exercises include a controlled squat to target tendonitis in your knees and an eccentric push up. Don’t worry if mobility is an issue as your physiotherapist will work with you to create exercises that are suitable for your level.

Along with rest, these kinds of exercises strengthen tendons to help them heal and prevent recurrences. 

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Shockwave Therapy

Shockwave therapy is a non-invasive treatment that uses sound waves to stimulate healing in the affected tendon. While it might feel a bit uncomfortable, it’s not overly painful and is actually designed to help relieve pain. By enhancing blood flow and accelerating tissue regeneration, shockwave therapy can significantly improve symptoms of tendonitis and tendinopathy. For many of our patients, this makes it a worthwhile option in their treatment plan.

This therapy, along with ultrasound, is effective in promoting connective tissue repair and reducing inflammation, though some studies have shown mixed results. If exercise alone isn’t working well for your tendonitis, shockwave therapy is a great alternative to try before considering more invasive options like surgery.

At-Home Exercises

Your physiotherapist will teach you the exercises you need to practise (including the eccentric exercises described above), but it is up to you to follow the instructions. This includes:

  • Not partaking in any activity that puts stress on your tendon or feels like a struggle,
  • Only exercising using the exact exercises you have been taught,
  • Exercising according to a schedule – no more or less frequent,
  • Not increasing the intensity or frequency of the exercises too early,
  • Resting when you are told to.

Physiotherapy for tendonitis isn’t difficult or rigorous, but it is important to follow the treatment plan to ensure it is effective.

Preventing Recurrences

The last – and arguably most important – part of your tendonitis physio treatment is understanding how to prevent the condition from recurring. Unless you make changes to your lifestyle and habits, your tendonitis could come back.

So, your therapist will give you some advice tailored to your specific needs. We may recommend a balanced exercise routine to strengthen the muscles around the affected tendon, improving support and reducing strain. This is really important if your job involves repetitive actions that will continue to put pressure on your tendon even after the tendonitis is healed.

Proper warm-up and cool-down techniques before and after activities are also emphasised to prevent overuse injuries. Ergonomic adjustments in your daily activities, such as proper posture and body mechanics, are essential to avoid unnecessary stress on your tendons too. Your therapist will explain what to do here. 

Physio for Tendonitis at One Body London

Finding a physiotherapist for tendon conditions like tendonitis and tendinopathy is essential for effective diagnosis and treatment – just ignoring your tendon condition won’t help it heal and it could lead to chronic tendon pain. Early intervention is always best!

Physiotherapy clinics offer a fast and convenient alternative to the sometimes lengthy NHS waiting times, allowing you to use your private health insurance to cover the cost. With expert assessment, personalised treatment plans, and ongoing support, our physiotherapists can help you manage and recover from tendon issues. 

Book an appointment with a skilled physiotherapist at one of our London clinics today to start your journey towards better tendon health and improved quality of life!

FAQs

Do physiotherapists treat tendonitis?

Yes, physiotherapists regularly treat tendonitis and tendinopathy using a combination of rest and exercises. Physiotherapy is actually the first recommended course of action for patients with tendonitis!

Who is the best person to see for tendonitis?

For tendonitis, a physiotherapist experienced in musculoskeletal physiotherapy is best. We know how to assess, diagnose and treat your tendonitis with rest and exercise.

When do you need surgery for tendonitis?

Surgery is only recommended for tendonitis if it does not improve with at least 6 months of physiotherapy. However, you should note that symptoms can recur even after surgery if you don’t make changes to your lifestyle.

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