Tendinitis and tendinosis are very common conditions we treat in the clinic.
These include common conditions such as:
- Patellar Tendinitis (jumper’s knee)
- Achilles Tendinitis
- Common Flexor Tendinitis (tennis elbow)
- Common Extensor Tendinitis (golfer’s elbow)
- Rotator cuff Tendinitis (impingement syndrome)
FIRST, I WANT TO ANSWER SOME OF THE MORE COMMON QUESTIONS REGARDING THIS TOPIC.
What is the difference between a tendon and a ligament?
Tendons are the thick fibrous cords that attach muscle to bone, as shown in the picture below.
Ligaments are the thick fibrous cords that attached bone to bone, as shown in the picture below.
Think of both tendons and ligaments is as large cable cords composed of many smaller individual units, which in combination have a lot of strength.
What is the difference between tendinitis and tendinosis?
Tendinitis is an acute injury that results from microtears of the tendon, usually it is because of an injury that causes the tendon to stretch beyond its normal range, causing inflammation, pain and swelling.
In contrast, tendinosis is a chronic condition. When you have repetitive overuse injuries and microtears, without giving the tendon enough time to rest and heal. Overtime, the actual integrity of the tendon fibers change and instead of normal healing, you get scar tissue formation within the tendon, also weakening the tendon. This is much more difficult to heal. Many acute episodes of tendinitis will eventually cause tendinosis.
Why does it take a long time for tendons to heal?
The problem that exists with both tendons and ligaments is they that have a poor blood supply. As a result, it is difficult to bring in the necessary nutrients to the site of injury for the repair mechanism to take place. This is why it takes a long time for tendons and ligaments to heal after injury.
This is also why treatments like Platelet Rich Plasma therapy (PRP) help augment the healing process by bringing the platelets and growth factors exactly to the site of healing. PRP is being more commonly used than the traditional Steroid (Cortisone shot) as it helps heal and repair the tendon rather than just mask the pain.
In addition, steroids end up weakening the tendon in the long term. More and more studies https://advheal.com/resources/ are showing evidence of PRP becoming one of the main conservative treatment for tendinopathies.
Finally, newer agent such as AmnioFix, which are placental derived growth factors containing over 200 growth factors, are being used more often with good results. We are now using AmnioFix for tougher cases for chronic tendinosis/tendinopathy and even partial tendon tears.
All the procedures are performed under ultrasound guidance so that the treating agent, whether PRP, Amniofix or other biologics, is delivered to the exact site of tendon injury to have the maximum effect.
The most important lesson to be learned is that tendinitis and tendinosis needs to be treated sooner than later. Persistent tendon inflammation and overuse will lead to continued weakening of the tendon and possible tear, making the treatment options become more limited. Surgery is the last option in the most severe cases but can avoided in the majority of cases.
Posted on behalf of Advanced Healing Institute
22972 El Toro Road
Lake Forest, CA, 92630
Phone: (949) 239-3206