We don’t know a lot about tendinopathy, but you should know a few immutable facts as a clinician and a patient.
1. Tendinopathy does not improve with rest, pain can calm, but a return to work is often uncomfortable since rest does not enhance tendon tolerance.
2. Although certain inflammatory biochemistry and tendinopathy cells exist, the classical inflammatory response is not considered. Anti-inflammatory diseases can assist, but the effects on the real cells and psychology are unknown.
3. There may be several risk factors causing tendinopathy. The major element in some activities is quick changes – they include 1) the activity requiring that the tendon store energy (i.e. walking, running, leaping) and 2) the load of the tendon. Biomechanics (e.g. low muscular capacity or endurance) or systemic variables lead certain persons to predisposition (e.g. age, menopause, elevated cholesterol, increased susceptibility to pain, etc). The substantial change in their activities may lead to tendon discomfort.
4. Exercise is the best-proven treatment for tendinopathy – tendons must be gradually loaded in order to acquire a better tolerance to stresses a person has to withstand in everyday life. Without this crucial stress input, in a great majority of cases (but not all), tendinopathy will not improve.
5. In settling tendon discomfort, the load changes are significant. This generally entails decreasing the abusive tendon stress, which involves energy storage and compression (at least in the short period).
6. Tendinopathy seldom improves throughout the course of the long term using passive therapies solely such as massage, ultrasound therapy, injections, shock wave therapy, etc. Training is typically the essential component and adjuncts are passive therapies. In particular, several injections should be avoided because this is frequently linked to a worse result.
7. You must individualize your exercise. This is dependent on the pain and function of the individual. The load should gradually rise, so that the target function may be restored while respecting discomfort.