Tag Archive for: tendinosis

Running Over 50: Top 3 Injuries and What you can Do

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If you love to run, then you’re probably no stranger to running injuries.

But if you love to run and you’re over 50, not only are you more likely to suffer a running-related injury compared to runners half your age, but you’ll tend to suffer from different categories of injuries as well. In older runners, we tend to see more soft-tissue related injuries versus problems with joints and stress fractures. Part of this is due to the fact that older runners may have been running longer. This predisposes them to more long-term wear and tear that is typically associated with soft tissue injuries like tendinopathy and plantar fasciitis. Older runners also are more likely to have altered their running mechanics over time, another factor that leads to injury. Either way, the good news is that once you know what to look for, you can take proactive measures to prevent these common running injuries as well as treat them naturally.

Here are the top 3 running injuries I see in people over 50 and what you can do:

1. Plantar Fasciitis

Plantar fasciitis is a condition characterized by a sharp, stabbing pain in your heel or bottom of your foot. It often worsens with the first steps in the morning or after long periods of rest. This discomfort comes from inflammation in your plantar fascia, a thick band of tissue running across the bottom of your foot from your heel to your toes. Factors such as overuse, improper footwear, high arches, flat feet, and tight calf muscles can all contribute to the development of plantar fasciitis, whether you’re a runner or not.

Prevention measures for plantar fasciitis include incorporating regular stretching and self-massaging of your plantar fascia and calf muscles before and after running. Balance exercises that focus on strengthening the intrinsic muscles of your foot, along with maintaining a healthy weight can also help – as it will allow you to better control and manage the load that gets transmitted through your plantar fascia. But what if you’re already suffering from pain due to plantar fasciitis? Don’t just resort to rest and ice, which has been known to impede healing. Plantar fasciitis requires prescriptive loading of your muscles in order to remodel the damaged tissue. This, along with non-invasive treatments such as Shockwave Therapy designed to enhance blood flow to the tissue, can aid in accelerating your healing.

2. Runner’s Knee (Patellofemoral Pain Syndrome)

Runner’s knee is a term used to describe a variety of conditions that cause pain around the kneecap (patella) – and is often synonymous with patellar tendonitis. You’ll notice your runner’s knee most during activities that require knee bending, walking downhill, or descending stairs. Overuse of your quadriceps muscles, poor tracking of your patella, and any other muscle or joint imbalance that results in increased load to the front of your knee can all result in runner’s knee. 

Regular and balanced strength training of the muscles around your knee – particularly of the quadriceps, hamstrings, and hip muscles – is a key prevention strategy. Making sure you have good ankle and foot mobility is also important. Because if your foot doesn’t move well when you run, unwanted forces move up the chain into your knee, eventually leading to runner’s knee. If you’re already suffering from runner’s knee, then you’ll want to first mitigate your pain. Similar to plantar fasciitis – rest and ice won’t do much for you. Getting blood flow to the area – followed by carefully prescribed exercises designed to restore your mechanics and properly load your patella tendon – is what’s going to heal the irritated tissue in and around your knee and make it stronger.

3. Achilles Tendinitis

Achilles tendinitis presents as pain and swelling in the back of your heel or lower calf. Right where your Achilles tendon connects your calf muscles to your heel bone. Your Achilles pain will typically be most prominent during or after running. It may be accompanied by stiffness when flexing your foot. While the causes of Achilles tendinitis are very similar to that of plantar fasciitis, we see this occur most often with sudden increases in intensity or duration of training. Particularly, this happens when your body is not adequately prepared.

A gradual increase in training load, regular calf strengthening and stretching exercises, and proper warm-up and cool-down regimens can go a long way in preventing Achilles tendinitis. Be cautious of your footwear as well. Minimalist running shoes have become extremely popular. But, if you move into them too quickly, your Achilles tendon could become irritated due to the sudden change in load and force. If you’re already suffering from Achilles tendinitis, the treatment is quite similar to that of plantar fasciitis. The exception is that when it comes to tissue loading, you’ll want to focus more on your lower calf and Achilles tendon, versus the plantar fascia.

With all of these conditions, keeping yourself healthy and in good shape is crucial for prevention.

Enlisting the help of a running coach is also a good idea. They can address any potential issues with your running mechanics that may have occurred over the years. If you’re picking up running for the first time, or returning to it later in life, take it slow and easy. Consider talking to a movement expert who can detect and analyze any imbalances in your body. They can ensure that you’re moving and exercising correctly. Imbalances will cause you to compensate. This is not something that will be immediately obvious to you – until it’s too late.

tendinosis

Why the Difference between Tendinitis and Tendinosis Matters

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Tendinitis and Tendinosis: Why the Difference between them Matters.

Many patients at our specialized physical therapy practice in Portsmouth, NH, suffer from either Tendinitis or Tendinosis. Tendinitis and Tendinosis sound very similar, and are often used interchangeably but they couldn’t be more different. And neither should their treatment regimen.

Tendonitis is an acute, short-term, inflammatory condition typically caused by repetitive overuse of your tendon.

Tendinosis, on the other hand, is a chronic, degenerative condition of your tendon that involves deterioration of collagen, a structural protein in your tendon.

Tendons are tight, yet flexible bands of fibrous tissue that connect your muscle to bone. Without tendons, your muscles would be useless. Tendons are extremely organized, and the fibers are designed in a way to withstand and transmit high forces of tension so your muscle can function properly.

With tendinitis, your tendon becomes inflamed and irritated, typically due to repetitive overuse, and it will hurt when you try to move. The most common areas for tendinitis to occur are your elbows, rotator cuff (shoulder), patella (knee), and Achilles tendon (ankle).

Tendonitis is an acute condition, and the best treatment is to rest, apply ice, and sometimes take anti-inflammatories to control pain. But this should only be for a short period of time. From there, you want to figure out what caused the tendinitis to occur in the first place and address that.

Typically, it’s due to some sort of mismatch between muscle strength and the activity you need to perform, leading your body to compensate and put unwanted stress on your tendon. Once you figure out and correct this pattern, it’s very easy to get rid of your tendinitis.

When you don’t manage tendinitis properly, and it goes on longer than a few months, it can result in tendinosis.

Tendinosis is a very different condition where the fibers in your tendon actually start to break down. An important thing to note is that tendinosis no longer involves inflammation of your tendon. So using ice every day, resting it, and taking anti-inflammatories will not help you, and could even worsen the condition.

Second, since tendinosis involves disorganization and degeneration of the fibers that make up your tendon, you have to “re-organize” those fibers and get blood flowing to the tissue (actually create some inflammation). Unresolved tendinosis leads to progressive weakening of your tendon over time – making it easily susceptible to full blown tears. This is how so many folks tear their Achilles or rotator cuff, for example, “out of nowhere”.

So how do you treat tendinosis and prevent more serious problems from happening down the line?

You have to get blood flow to the area and re-organize those fibers so your tendon can work properly again. Passive treatments like ice, rest, and medicine will not help tendinosis.

The only exception is shockwave therapy (also known as Extracorporeal Pulse Activation Technology).

With shockwave therapy, high-energy sound waves stimulate the body’s natural healing mechanisms by increasing blood flow to the injured, affected area. The increased blood flow delivers oxygen and nutrients to the damaged tissue to help accelerate healing and reduce inflammation.

With pain reduced and the healing process promoted, your tendon is now primed for physical rehabilitation and re-organization of the tendons, the next most essential part of getting rid of your tendinosis.

The only way to truly re-organize tendons is to put stress on them so they can “remodel”. To do this, you have to put just the right amount of stress to cause a little bit of pain (inflammation) – but not so much that your tendon gets inflamed again.

This is literally one of the few times where “no pain no gain” actually holds true. A properly trained physical therapist who is well-versed in tendinosis rehabilitation will know how to do this and can guide you through it.

You have to retrain the fibers in your tendon to withstand normal forces again – and this process takes both time and careful loading strategies.

The good news, however, is that if you rehab your tendinosis properly, you can get back to all the activities you love again as if nothing ever happened. You don’t have to accept this as a chronic condition.

If you’re confused on tendinosis and tendinitis after reading this don’t worry – so is half the medical community.

The take home points to remember are that tendinitis involves pain and inflammation. There is no damage to your tendon, and it only lasts about 4-6 weeks.

Treatment for tendinits should involve passive modalities like ice and rest. The focus should be on what caused your tendon to get irritated in the first place. Then, you can get rid of it before it turns into tendinosis.

If the problem in your tendon has gone on longer than 3 months, you must suspect tendinosis. This no longer involves inflammation but instead, a breakdown of your tendon. Passive treatments (with the exception of shockwave therapy) will not work. They could actually prolong your problem – so stop icing and resting.

To get rid of tendinosis, it requires carefully prescribed loading strategies, aka strengthening. That will properly re-organize your tendon so that it can be strong and functional again. This is extremely challenging to do on your own.

So it’s a good idea to talk to an expert about this. If you are local to and looking for physical therapy in Portsmouth, NH, reach out to schedule a FREE 30 minute discovery session.

Tendonisis

Tendonitis vs. Tendinosis – The BIG difference and why it matters

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If you’ve ever suffered from tendonitis or tendinosis – then you know that it can last anywhere from a few weeks to several months!

Tendonitis is an acute, short-term, inflammatory condition typically caused by repetitive overuse of your tendon. Tendinosis, on the other hand, is a chronic, degenerative condition of your tendon that involves deterioration of collagen, a structural protein in your tendon.

While the two conditions sound very similar and are often used interchangeably, they couldn’t be more different. When tendonitis isn’t caught early enough or treated properly it can turn into tendinosis. The treatment for acute tendonitis is very different from chronic tendinosis.

Let me explain…

Tendonitis is an acute condition. The best treatment is to rest, apply ice, and sometimes take anti-inflammatories to control pain. From there, you want to figure out what caused the tendonitis to occur in the first place and address that.

Typically, it’s due to some sort of mismatch between muscle strength and the activity you need to perform, leading your body to compensate and put unwanted stress on your tendon. Once you figure out and correct this pattern, it’s very easy to get rid of your tendonitis!

The most common areas for tendonitis to occur are your elbows, rotator cuff (shoulder), patella (knee), and Achilles tendon (ankle).

When you don’t manage tendonitis properly, and it goes on longer than a few months, it can result in tendinosis. Tendinosis is a very different condition where the fibers in your tendon actually start to break down. The first thing to note is that tendinosis no longer involves inflammation of your tendon. So using ice every day, resting it, and taking anti-inflammatories will not help you. I can’t tell you how many times I’ve spoken to people still doing this 6-8 months later…

Second, since tendinosis involves disorganization and degeneration of the fibers that make up your tendon, you have to “re-organize” those fibers in order to resolve tendinosis and get your tendon functioning properly again.

Passive treatments like ice, rest, and medicine will not help tendinosis. They might help to relieve any pain you’re having from overdoing it or under-treating it… but the tendinosis will continue to progress. Unresolved tendinosis leads to progressive weakening of your tendon over time – making it easily susceptible to full blown tears. This is how so many folks tear their Achilles or rotator cuff, for example, “out of nowhere”.

Once I speak with them, they often report that over the years they had recurring bouts of tendonitis in that area. In other words, their tendonitis wasn’t managed properly and it led to chronic tendinosis. Making them an easy target for a torn tendon.

So how do you treat tendinosis and prevent more serious problems from happening down the line?

You have to re-organize those fibers so your tendon can work properly again!

Sounds easy, right? Well technically it is, but the biggest problem is that this process takes time – up to 9 months in many cases. And most patients I come across simply don’t have the patience for this. Or they simply aren’t told about it.

The other issue is that if you’re expecting an insurance company to cover your treatment – they typically don’t want you in physical therapy for more than 6-12 weeks at a time. This is not long enough to properly treat tendinosis.

The only way to re-organize those tendons is to put stress on them – and over a period of time. You have to put just the right amount of stress to cause a little bit of pain. However, not so much stress that your tendon gets inflamed again. A properly trained physical therapist that is well-versed in tendinosis will know how to do this.

You basically have to retrain the fibers to withstand force again – and this process takes time. The good news, however, is that if you rehab your tendinosis properly, you can get back to all the activities you love as if nothing ever happened!

If you’re confused after reading this don’t worry. So is half the medical community.

The take home points to remember are these:

Tendonitis involves pain and inflammation, there is no damage to your tendon, and it only lasts about 4-6 weeks. Treatment for this should involve passive modalities like ice and rest. The focus should be on what causes the tendon to get irritated innitially.

But if problems in your tendon have gone on longer than 3 months, you MUST suspect tendinosis. This no longer involves inflammation but instead, a breakdown of your tendon.

Passive treatments will NOT work and could actually prolong your problem – so stop icing and resting.

To get rid of tendinosis, it requires carefully prescribed loading strategies. These will properly re-organize the tendon so that it can be strong again! This is extremely challenging to do on your own, so we recommend working with an expert who is well-versed in this diagnosis.

Luckily – we’ve introduced a brand new treatment modality in our office. It accelerates the healing of soft tissue and tendon injuries.

It’s called Shockwave Therapy and we are currently accepting new patients for this service. If you’re already a client – you will get this service at no charge. Just ask your specialist next time you’re in and see if you’d be a good fit for this treatment.

But if you’re not a current client – and are currently suffering from something like plantar fasciitis, tendonitis, or some other soft tissue strain or injury – you could be perfect for this treatment! Studies have shown about 70% reduction in symptoms in as little as 6 sessions.

While this won’t completely “fix” your tendon or soft tissue problem – it can have a significant reduction on your pain which will allow you to more easily do the work that WILL fix your problem.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

plantar fasciitis

Tendonitis versus Tendinosis: The Big Difference and Why it Matters

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Tendonitis is a term you’re likely familiar with. You’ve probably even suffered from it at some point in your life. It’s an acute, short-term, inflammatory condition typically caused by repetitive overuse of your tendon. Tendinosis, on the other hand, is a chronic, degenerative condition of your tendon. It involves deterioration of collagen, a structural protein in your tendon.  While the two conditions sound very similar, and are often used interchangeably, they couldn’t be more different. And the treatment for each condition should be different too.

Tendons are tight but flexible bands of fibrous tissue that connect your muscle to bone.

 

Without tendons, your muscles would be useless. Tendons are extremely organized, and the fibers are designed in a way to withstand and transmit high forces of tension so your muscle can function properly. 

With tendonitis, your tendon becomes inflamed and irritated, typically due to repetitive overuse.

 

Tendonitis causes pain when you try to move. The most common areas for tendonitis to occur are your elbows, rotator cuff (shoulder), patella (knee), and Achilles tendon (ankle). Tendonitis is an acute condition, and the best treatment is to rest, apply ice, and sometimes take anti-inflammatories to control pain. From there, you want to figure out what caused the tendonitis to occur in the first place and address that. Typically, it’s due to some sort of mismatch between muscle strength and the activity you need to perform, leading your body to compensate and put unwanted stress on your tendon. Once you figure out and correct this pattern, it’s very easy to get rid of your tendonitis!

When you don’t manage tendonitis properly, and it goes on longer than a few months, it can result in tendinosis.

 

Tendinosis is a very different condition where the fibers in your tendon actually start to break down. An important thing to note is that tendinosis no longer involves inflammation of your tendon. So using ice every day, resting it, and taking anti-inflammatories will not help you. I can’t tell you how many times I’ve spoken to people still doing this 6-8 months after an unresolved tendonitis issue. Second, since tendinosis involves disorganization and degeneration of the fibers that make up your tendon, you have to “re-organize” those fibers in order to resolve tendinosis and get your tendon functioning properly again. 

Passive treatments like ice, rest, and medicine will not help tendinosis.

 

They might help to relieve any pain you’re having from overdoing it or undertreating it — but the tendinosis will continue to progress. Unresolved tendinosis leads to progressive weakening of your tendon over time, making it easily susceptible to full blown tears. This is how so many folks tear their Achilles tendon or rotator cuff, for example, “out of nowhere.” Once I speak with them, they often report that over the years they had recurring bouts of tendonitis in that area. In other words, their tendonitis wasn’t managed properly and it led to chronic tendinosis, making them an easy target for a torn tendon.

So how do you treat tendinosis and prevent more serious problems from happening down the line?

 

You have to re-organize those fibers so your tendon can work properly again! Sounds easy, right? Well technically it is, but the biggest problem is that this process takes time, up to 9 months in many cases. And most patients I come across simply don’t have the patience for this… or they simply aren’t told. The other issue is that if you’re expecting an insurance company to cover your treatment, they typically don’t want you in physical therapy for more than 6-12 weeks at a time. This is not long enough to properly treat tendinosis.

The only way to re-organize those tendons is to put stress on them.

 

You have to put just the right amount of stress to cause a little bit of pain, but not so much that your tendon gets inflamed again.  This is literally the one time where “no pain no gain” is actually true. A properly trained physical therapist who is well-versed in tendinosis will know how to do this. You basically have to retrain the fibers to withstand force again – and this process takes time.  The good news, however, is that if you rehab your tendinosis properly, you can get back to all the activities you love as if nothing ever happened!

If you’re confused after reading this, don’t worry – so is half the medical community. The take home points to remember are that tendonitis involves pain and inflammation, there is no damage to your tendon, and it only lasts about 4-6 weeks. Treatment for this should involve passive modalities like ice and rest, and the focus should be on what caused your tendon to get irritated in the first place. 

But if problems in your tendon have gone on longer than 3 months, you must suspect tendinosis, which no longer involves inflammation but instead, a breakdown of your tendon. Passive treatments will NOT work and could actually prolong your problem – so stop icing and resting. Getting rid of tendinosis requires carefully prescribed loading strategies (aka strengthening) that will properly re-organize your tendon so that it can be strong again! This is extremely challenging to do on your own, so it’s a good idea to talk to an expert about this. You can even schedule a FREE Discovery Session with one of our experts today!