Tendinitis vs tendinopathy? A physical therapist’s thoughts…
Countless times, I have sat with a patient as they explained how they saw a doctor and were diagnosed with some form of tendinitis whether it was patellar tendinitis, Achilles tendinitis or something else. They go on to explain how they were told to rest and take an NSAID and that should help their pain. A month later and they still are dealing with the same pain/symptoms. Now, they are sitting in front of me as I have to explain what is really going on.
According to Merriam-Webster, the definition of “itis” is a disease characterized by inflammation. Meaning, if there was truly inflammation going on in that region, it should respond well to rest and use of NSAIDs (nonsteroidal anti-inflammatory drug). The NSAIDs don’t usually do the trick because there is no inflammation present and that’s where properly labeling conditions can play a role. Words matter and I think, as a medical professional, the proper use of terms can go a long way in the recovery/healing process. A better team referring to some irritation in the patellar tendon is patellar tendinopathy. According to the Cleveland clinic, tendinopathy is a broad term for any tendon condition that causes pain or swelling.
The reason I believe words matter is because it sets expectations for the patient. If I was told I had tendinitis and I needed to rest, I would be afraid to do much activity at all as I could make things worse. Now, we are still dealing with pain and encouraging a sedentary lifestyle that leads to more issues. With most tendon pain that I have seen, it is actually the opposite that is needed. Tendons themselves have poor blood flow and they respond best to load. This load that the tendon goes through remodels the tendon, eventually becoming stronger in the long run. This strengthening is what will allow someone with pain to see improvement and continue with their active lifestyle.
Properly loading a tendon can be done through many different exercises and in a variety of ways like utilizing isometric or eccentric contractions. Some of my favorites are wall sits for knee pain and slow eccentric heel raises off a step for Achilles pain.
If you are someone who has been diagnosed with tendinitis or dealing with any sort of pain, the team over at Loon State Physical Therapy is able to help. We serve the twin cities communities with locations in Lake Elmo, Linden Hills and Minnetonka. Feel free to call us at (612) 405-8503 or book online at www.loonstatephysicaltherapy.com for an in-person or virtual appointment.
Loon State Physical Therapy approaches physical therapy with a fitness forward approach and specializes in treating the active adult. We look forward to working with you!
https://my.clevelandclinic.org/health/diseases/22289-tendinopathy