Tendinopathy: Understanding and Managing Your Tendon Problems

Mar 27, 2019

As with many things in life, tendon problems are not always simply defined. There is often much more to a situation such as “my Achilles hurts” than one may expect or want.

Trust us, we wish it were simple, too. If every problem had the same underlying causes and required the same treatment, we would be a much happier and healthier society as a whole!

But our bodies are much too wonderfully complex for such simplicity. When it comes to addressing tendon problems, we must consider multiple issues as well as the underlying causes of them we will need to address.

When we refer to tendon problems in general, you might hear terms such as “tendon pathology” or “tendinopathy.” Within these umbrella terms are more specific conditions that can befall a tendon. There are significant differences between these conditions, and those differences have significant effects on the ways each particular problem should be treated.

What Are They Talking About When Discussing my Tendons?

The tendons of the ankle area are grouped into a sort of family. While we try to be as direct and helpful as possible when discussing problems with our patients, you might hear references elsewhere that might be confusing for the standard individual.

The tendons of the ankle area can be divided into four “quadrants”:

 

  • Posterior (back side) is home to the Achilles tendon, the largest tendon that connects the largest calf muscle to the heel bone.
  • Medial (inside) is home to the posterior tibial tendon, which connects a calf muscle to the bones of the inner foot, and the two long flexor tendons, which run from the leg muscles to the toes.
  • Anterior (front) is home to the tibialis anterior tendon, which lies on the inner front of the ankle and aids in flexing the foot upward, and the two long extensor tendons, which connect to the toes and work opposite the long flexor tendons.
  • Lateral (outside) is home to the two peroneal tendons, which lie behind the outer ankle bone.

Isn’t it all Tendinitis?

While “tendinitis” is the most often-heard term when referring to tendon injuries (especially when the Achilles is involved), it does not properly describe all forms of tendon pain.

Sources of tendon pain can be divided into three main categories: tendinitis, tendinosis, and tendon tears/ruptures. Each has its own unique defining factors that guide us toward the best forms of treatment.

Tendinitis

Tendinitis refers to the inflammation of a tendon. (Anything you see with the suffix “-itis” refers to inflammation in some way.)

In most cases, the tendon has become irritated by an acute injury that has overstretched or overworked the tissue, causing it to grow inflamed and painful. A common real-world example is overdoing it during a weekend pick-up basketball game, especially if you stormed the court and didn’t take time to warm up beforehand.

The inflammation of tendinitis can occur within the body of a tendon or its sheath (a layer of membrane around the tendon). It can also occur where the tendon connects or “inserts” into a bone. When we say “insertional Achilles tendinitis,” for example, we are talking about the spot where the Achilles tendon inserts into the heel bone.

Tendinosis

Tendinosis refers to the degeneration and deterioration of a tendon over time, often the result of long-term overuse. Inflammation is not typically associated with this condition. Instead, the tendon tends to thicken and become pained.

Achilles tendinosis is something you might expect to develop if you have been following improper sports protocols (e.g. not warming up, using the wrong footwear, employing the wrong techniques, not taking enough rest days) over a long period of time. It might also be more likely to occur if you have an abnormality in foot structure that places steady, excess pressure on the tendon.

Tendon Tears and Ruptures

While tendinitis and tendinosis might include tiny “microtears” in a tendon, a defined “tear” in the body of a tendon is much more pronounced.

Tears tend to be longitudinal, along the length of a tendon. When the foot and ankle are concerned, tears are more likely to happen in the peroneal tendons or the posterior tibial tendon. However, any tendon can develop a tear.

A rupture is a complete tear of the tendon, and is associated with severe pain and sudden loss of mobility and strength in the affected area. Just as with tears, any tendon around the ankle can develop a rupture. The Achilles tendon is the most frequent tendon to be ruptured, though.

 

Treatment Options for Tendon Problems

Having the proper diagnosis for any source of pain is the first step toward finding the most effective treatment.

If you experience sudden foot or ankle pain during activity, or have had persistent pain for more than a couple days without improvement, your wisest move is to stop doing whatever might have caused or be aggravating that pain (sometimes your body won’t give you much choice to continue!) and contact us about it as soon as possible.

Attempting home treatment, especially if you don’t know exactly what you’re dealing with, might result in prolonged or improper recovery, which can lead to further and worse problems down the line.

Methods of treating tendon problems can vary depending on type and severity. Minor cases of tendinitis may only require a period of rest and icing. Worse cases might benefit greatly from our multiwave locked system (MLS) laser therapy, which is especially effective for reducing pain and inflammation from tendinitis.

For many ruptures and many longitudinal tears, surgery may be necessary to repair the tendon. If it is, we will be sure to discuss the full procedure and any other potential options with you to ensure you make a decision with full confidence.

If need help for any kind of painful foot or ankle issue, do not wait any longer than you need to. Call our Commerce Township office at (248) 360-3888 or fill out our online contact form to request an appointment.

Phone Number

Location

9640 Commerce Rd Suite 102 Commerce Township, MI 48382

Hours

Monday 8:30am – 5:00pm
Tuesday 7:45am – 5:00pm
Wednesday 8:30am – 4:30pm
Thursday 9:00am – 6:00pm
Friday 9:00am – 3:00pm
Saturday Occasional
Sunday - Closed -

Hours

Monday 8:30am – 5:00pm
Tuesday 7:45am – 5:00pm
Wednesday 8:30am – 4:30pm
Thursday 9:00am – 6:00pm
Friday 9:00am – 3:00pm
Saturday Occasional
Sunday - Closed -

9640 Commerce Rd Suite 102 Commerce Township, MI 48382

Fax

(248) 363-0894

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