Tendonitis and Treatment

 

What is Tendonitis?

Tendons are thick fibrous tissues made that connect muscle to bone, they are elastic in nature and have to “stiffen” when our muscles contract. For example, to move your shoulder, the tendon that connects your shoulder muscles to your shoulder joint stiffen as a response of the muscles contracting resulting in movement. Tendonitis is when this fibrous tissue becomes inflamed.  Inflammation of tendons ca n be expressed as pain, tenderness or mild swelling initially, if left untreated, tendonitis could lead to the need of surgical intervention.

Where could Tendonitis happen?

Tendonitis can occur wherever tendons are, the most commonly affected areas are shoulders, elbows, wrists, thumbs, hips, knees and heels as those tend to be the most commonly used joints

What causes Tendonitis?

  1. Age

Tendons are made up of collagen, the production of collagen decreases with increasing age. This causes tendons to be less flexible and more prone to injuries; this is often seen in people over the age of 40.

  1. Activity

Specific sports or repetitive movements are another cause. If the nature of sport or work includes repetitive and/ or forceful movements, it leads to recurring high loads of tension on a specific joint/ tendon. Overtime, this leads to the tendons deterioration which is exacerbated as inflammation of the tendons in its early stages. Golfers and overhead reaching during work are examples of such activities that include forced repetitive movements, potential incorrect posture and body movements are other causes. Furthermore, the incorrect equipment, for example non-supportive shoes or uneven and hard surfaces such as running on gravel could lead to tendonitis.

  1. Medications and Health

Some medications such as antibiotics or corticosteroids might elevate the risk of developing tendonitis. Diseases such as diabetes also increase risk of developing tendonitis.

How to Treat Tendonitis?

Early intervention is the best for tendonitis, if tendonitis is left without treatment and injury pertains, it could develop into a tear that may need surgical intervention. Treatment can be broken into passive and active phases:

Passive Treatment:

Prescribing anti-inflammatory medication to help reduce the inflammation of the tendon is usually one of the early steps to treat tendonitis. When treating acute tendonitis, treating therapists follow the P.R.I.C.E principle, which is

  • Protection: use devices or tools to prevent further injury, for example splints, protective tape and ace bandages.
  • Rest: stop activities that have lead to the overuse of the tendon. Determining the cause and resting are the major steps of preventing further inflammation and deterioration of tendons.
  • Ice: ice the injured area for 20 minutes at a time; this is hugely beneficial in the initial weeks of the injury to reduce inflammation levels.
  • Compression: after icing the area, a compression wrap should be applied to act as a mechanical barrier reducing any ongoing swelling.
  • Elevation: similar to icing, elevation has great benefits when applied immediately post-injury. Elevation helps reduce blood flow to the injured area reducing swelling and inflammation.

Other than PRICE and anti-inflammatory medication, Inferential current therapy (IFC), Transcutaneous electrical nerve stimulation (TENS), ultrasound treatment and other physiotherapy modalities can be used to aid in the process of recovery.

Active Treatment:

Passive Treatments on their own are not enough to fully treat musculature injuries, hence why active physical therapy treatment should always be coupled with passive treatment when possible. When it comes to tendonitis injuries, it varies among individuals, based on the degree of the injury but also how long has it been since the tendons started being affected.

Exercise within the early stages of the injury could lead to more strain and inflammation of tendons, hence should be avoided. Once cleared by the treating therapist, strengthening the muscles surrounding the joint and connected to the injured tendon is the goal in order to prevent future injury.

Active recovery focuses on improving range of  motion (ROM) of the joint and stretching potential of the tendon itself. Once patients improve in those aspects, strengthening exercise of the muscles will be incorporated. Stretching and ROM exercises insure that not only the muscle, but the tendon itself is getting accustomed to a healthier range of motion. Strengthening exercises lead to better muscles connected to the injured tendon, better and stronger musculature decrease the risk of injury greatly.

Future Tips for Prevention

After passive exercise has begun, active recovery must always be incorporated. Once you think you are done treatment, stretching and warming up before any exercise or strenuous activity should always be the first step. To avoid future injury after recovery:

  • Rest when in pain and discontinue cause of injury.
  • Warm up and stretch thoroughly before sports and exercises, cool down after and stretch again.
  • Stretch before beginning work, and take mini breaks to move your muscles around to give them a break from repetitive movements at work.
  • Focus on building muscles strength and flexibility.
  • Use the correct equipment and proper range of motions for activities.

 

Sources:

https://www.mayoclinic.org/diseases-conditions/tendinitis/symptoms-causes/syc-20378243

https://www.sportsmd.com/sports-injuries/knee-injuries/how-to-treat-tendonitis/

https://www.sportsmd.com/acute-sports-injury-treatment-using-p-r-c-e-principle/

https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=1&contentid=739

https://www.webmd.com/fitness-exercise/arthritis-tendinitis

https://www.endeavorrehab.com/2020/07/17/treatments-for-tendonitis-with-physical-therapy/

https://www.mayoclinic.org/diseases-conditions/tendinitis/symptoms-causes/syc-20378243

 

 

 

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Welcome Dr. Asaro

Tony

Dr. Asaro , Doctor of Chiropractic, who has joined our Main Street Health team of health professionals, has 15 years of experience providing patient centric, quality chiropractic care with an emphasis on prevention, multidisciplinary rehabilitation and patient education.

A spine specialist, advanced practitioner for low back pain and sciatica working for a the hospital program at HHS with surgeons, pain specialists and family doctors.

He has extensive experience in working with patients with musculo-skeletal conditions and inflammatory and non-inflammatory conditions and is highly trained at identifying the signs and symptoms of undiagnosed medical conditions.

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Does Your Foot Hurt When Jogging? Here’s Why, and How to Fix It

Jogging is an increasingly popular hobby and fitness routine, with reports estimating participation in the activity has increased nearly 20x over the last three decades.

Jogging is undeniably a great hobby and sport, contributing to living a healthy, active life. But it can have its drawbacks. Joggers pounding the pavement often find themselves facing a myriad of discomforts regarding their feet.

Apart from the usual blisters and hard calluses, many runners suffer from long-term, nagging injuries that can make it difficult to jog consistently and comfortably.

This guide will cover some of the more common conditions and injuries joggers face, and how to heal from them quickly.

Plantar Fasciitis

The major tendon running along the bottom of the foot is at the highest risk of inflammation from jogging. This condition often shows up without warning, like stepping on a nail. Plantar Fasciitis may originate from a variety of causes, often due to poorly fitted shoes, lack of foot support, gait, or not pacing yourself.

If your only pair of running shoes are too flat or worn down, you may need a new pair or some supplementary insoles to provide added support. For those affected, it may take between weeks to months for a full recovery. During this time ice, rest, and stretching are advised to help speed the process along.

Stress Fractures

We’re all familiar with the mantra, “No pain, no gain”. For joggers and runners out there, this catchphrase couldn’t be more off base, and is just how stress fractures can start to rear their ugly head. This condition may first present as localized pain, often in related muscle groups or more intensely in shins.

As the condition progresses you may no longer be able to jog without clenching your teeth in pain. Stress fractures happen over time, similar to tendonitis. You’ll need an MRI to confirm whether or not you have a fracture.

If the diagnosis is indeed a stress fracture, the path to recovery is rest, ice, compression and elevation.

Achilles Tendon Injury

This tendon is comprised of a tough band of fibrous tissue connecting the muscles of the calf to the heel bone. This tendon can become inflamed, torn, or ruptured as a result of overtraining or due to sports or work-related movements and activities. Proper footwear, support, stretching and conditioning in conjunction with a well-planned training regimen can reduce your risk for developing an injury. Only a medical professional can diagnose tendon injuries, after which they may suggest rest, ice, compression, elevation, heat, pain relievers, improved footwear, immobilization or other treatment options.

Ankle Sprains

Rolling your ankle loss of concentration, poor form, improper foot and ankle support and uneven ground are just a few of the most common causes of ankle sprains among joggers. There are two types of ankle sprains: high and low. High ankle sprains are common in sports because they involve a lot more force and twisting actions.

Most joggers will only experience the more common low ankle sprain, involving ligaments below the ankle joint. A cold compress with the foot elevated is usually all that is needed to recover from an ankle sprain. We recommend waiting a day and pacing yourself when returning to jog.

Need Help Recovering from an Injury?

At Main Street Health we’re dedicated to helping you get back up on your literal feet in no time. Our team of dedicated and talented medical and rehabilitative professionals are caring and experienced, providing cutting-edge custom-tailored support, therapeutic and rehab treatment protocols to get you back to your old self in no time. Call or drop by today to learn more.

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Best 4 Simple Stretches to Ease Groin and Hip Pain

Stretching increases oxygen levels and helps jump-start muscle-building. Stretching after your workouts is just as important as stretching before them. When it comes to exercise-related groin and hip pain, stretching is often one of the best remedies for reducing both its frequency and intensity.

You don’t need a personal trainer to do these four simple stretches at home. Remember to always take a few minutes to warm-up before stretching in order to prevent hyper-extensions and injury.

And if you’ve been experiencing groin and hip pain due to injury, arthritis, inflammation or other causes, don’t hesitate to reach out to our dedicated and talented team at Main Street Health today to get the help you deserve.

Stretches to Ease Groin and Hip Pain

1. Seated Floor Stretch

The first stretch you should begin with takes place while seated on the floor. This stretch will target your core and your hips. First, start with your legs together and your back straight. Next, lean forward as far as you can with your arms out.

Grab the furthest point your hands can reach and hold this position for between 20 to 30 seconds. Release, then spread your legs apart and repeat this same stretch. You should start to feel your hips open up and your lower back extending.

This is a great exercise to do before hopping out of bed every morning. It can help increase your energy levels and reduce stiffness.

2. Squatting

Doing squats is essentially an advanced form of stretching. You will get a lot of mileage out of squatting for groin and hip health so long as you maintain proper form. Start by standing straight, feet shoulder-width apart.

Breathe in as you dip down, stopping with your knees just above your toes. Resist the urge to go down further than that or you’ll place too much pressure on your knees. After about five seconds, breathe out as you ascend back up.

If you so desire and if you’re ready for it, a kettlebell or other weight can be included to further develop hip, glute, hamstring and quadriceps musculature while increasing your range of motion. It is important to note that squats work best as a preventative stretch, as they can become too intense when you’re already in pain.

3. Bending the Knee

As an alternative to squats, you can achieve similar results from simply kneeling down. Start with your feet together, then squat all the way down with your knees on the floor. With your feet under your butt, place all your weight on your toes and hold it for 30 seconds.

Carrying out this stretch against a wall can help with your balance. When in position, you can slowly open and close your legs. This will stretch out all your joints and ligaments slowly. You should feel your hips and groin loosen up while in this position.

4. Heisman Lunges

If you’re looking for a more intense stretch and strengthening exercise combination, lunges are great for both. We recommend starting with standard forward lunges before moving on to Heismans. The difference between the two is subtle, but important.

Heisman lunges take your forward stretch and add in a twist. As you descend into your lunge, you turn to the left or right. Twist until your elbow crosses your thigh opposite to it. Hold this position for 30-60 seconds each time.

For added strength training, you can carry a weight in your hands.

Need More Assistance? – call or reach out today

From sports and work injuries to accidents and chronic conditions such as arthritis, our team of dedicated and talented medical and rehabilitative professionals at Main Street Health are ready and eager to help. Call today to set up an appointment.

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The Top 3 Most Common Running Injuries and How to Avoid Them

According to the Road Runners Club of America (RRCA) and Active.com, between 65-80% of runners will end up with a running-related injury each and every year. If you’re a runner this statistic might seem alarming. Fact is, the odds aren’t in your favour.

That’s the bad news. The good news is that there are simple and effective things you can incorporate into your training regimen to prevent these injuries from occurring in the first place.  If you don’t find the following helps you call Hamilton physiotherapy clinic today!

In this guide, we’ll discuss the three most common running injuries, what they are, why they happen, and what you can do to avoid them. If you are currently dealing with a sports-related injury consider reaching out to our team for help. At Main Street Health we are experienced and adept at accurately assessing and diagnosing underlying causes of injuries and pain, helping you get back on your feet in no time.

  1. Runner’s Knee

Medically known as patellofemoral pain syndrome or “PFPS”, runner’s knee involves the inflammation and irritation of cartilage located under your kneecap (patella). According to a Runners World poll, knee-related injuries comprised around 40% of all running-related injuries each year.

Who is at Risk for Runner’s Knee?

Risk factors are for this type of injury generally involve biomechanical issues that result in additional stress being placed on the knee joint. Examples include weak quadriceps, hips, glutes and over-pronation (inward rolling of the foot).

What do Do If You Already Have it?

Consider taking additional rest and recovery days between running sessions or reducing how many miles a week to run. If symptoms persist physical therapy may prove useful.

How to Prevent Runner’s Knee?

  • Incorporate uphill running into your training
  • Reduce downhill running
  • Add bicycling into your routine
  • Opt for low impact knee-friendly activities including swimming and elliptical training
  • Incorporate strength training for your glutes, hip and quads
  • Add in lateral side steps into your training
  • Focus on reducing stride length on runs
  • Focus on landing each stride with your knee slightly bent to reduce impact load on the joint
  • Count the number of steps taken per minute running and increase that rate by 5-10% per each minute
  • Warm up before each training session
  • Routinely stretch to keep joints and muscles flexible and elastic

 

  1. Achilles Tendinitis

This injury involves, you guessed it, the Achilles tendon. This tendon, located at the posterior of your heel, connects your two primary calf muscles to your heel. When overworked or under high loads of stress, this tendon can become inflamed and quite painful.

Who is at Risk for Achilles Tendinitis?

Those with weak posterior leg musculature such as glutes, hamstrings and calves, as well as those with poor flexibility especially in the muscles of the calf. Dramatically increasing training volume, load, hills and speed work may also contribute to this injury.

What do Do If You Already Have it?

Back off your training for a while. With this type of injury, it is not recommended that you “work through it”. Failing to allow time for minor tendinitis to heal could result in a more severe case necessitating months of recovery time. Consider physiotherapy or rehabilitation as a means to safely get back to training.

How to Prevent Runner’s Knee?

  • Increase muscle strength and endurance of the glutes, calves and hamstrings by incorporating resistance work into your routine. Squats, burpees, lunges and calf raises are a good place to start.
  • Practice eccentric heel drops in order to strengthen the calves themselves.
  • Incorporate elliptical machine training, pool running and swimming into your routine.
  • Avoid aggressive calf stretching but do keep limber.
  • Avoid wearing heels and sandals (both of which irritate the Achilles tendon.

 

  1. Hamstring Injuries

Those muscles that run down the back of your thighs are called hamstrings. These muscles are responsible for bending our knees, extending our legs, pushing us up inclines and powering up kicks. But when they become too weak or rigid to perform, they can cause serious discomfort and even injury.

Who is at Risk for Hamstring Issues?

Those with genetically long or short hamstrings. Hamstrings that are either too rigid or even too flexible (i.e. overly stretched and prone to damage). Muscle tightness. And those with a disproportionate muscle imbalance, particularly as it relates to the quadriceps and hamstrings.

What do Do If you Already Have Issues?

Pain that is acute and that comes on suddenly may be indicative of a true “pulled” muscle and you may require prolonged rest, ranging from weeks to months. Having your issues evaluated by a physiotherapy professional is advisable as they may be able to suggest rehabilitative exercises and stretching that can help you on the path to a faster recovery.

How to Prevent Hamstring Issues:

  • Incorporate strengthening exercises such as one-legged deadlifts
  • Utilize a foam roller to gently reduce muscle tightness both before and after runs
  • Deep tissue massage may prove beneficial
  • Incorporate bridge exercises into your regimen
  • Consider wearing compression tights

 

Closing Thoughts Regarding Running Injuries

Injuries sustained from running are quite common and can range from minor aches and pains to debilitating injuries that require lengthy recovery times.

If you have been injured or are experiencing pain during your sessions it is advisable to seek out the help of a trained professional. At Main Street Health our team can quickly and accurately diagnose any issues you may be experiencing and set you up with a rehabilitation plan aimed at getting you back on track in no time.

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