Tag: tendons

Don`t take ibuprofen to stop inflammation for Arm Wrestling. This is killing your gains.

Many physicians consider NSAIDs to be the medication of choice for managing musculoskeletal pain and injury. However, studies have questioned their value in the healing process of bone, muscle, tendon, and ligament injuries and their use carries the risk of potentially serious adverse effects. Animal and human studies have linked NSAID use to poor fracture healing. There appears to be little role for NSAIDs in tendinopathy outside of initial symptomatic pain relief. Animal studies provide conflicting evidence of efficacy in ligament injury, but human trials suggest that short courses may be of benefit in acute injury. Experimental animal models mostly demonstrate no effect on muscle healing or a reduction in muscle strength. Alternatives for analgesia in musculoskeletal injuries include acetaminophen, opiate-containing medication, and topical preparations. (J Musculoskel Med. 2011;28:207-212)

Tendon injury
The treatment goal for tendinopathy, as for fractures, is decreased pain and return to normal function. The term “tendinopathy” has been associated with both chronic tendon degeneration (tendinosis) and acute injury (tendinitis). The majority of tendon disorders are deemed to be chronic, degenerative changes (tendinosis rather than tendinitis) and acute tendon injury resulting from overloading of tissue that already has undergone degenerative changes.

Studies have demonstrated that prostaglandins and leukotrienes are produced during the acute phase of a tendon injury and may be involved in the subsequent degenerative changes over the long term. In the first few days after acute tendon injury, there is an initial inflammatory phase with angiogenesis, increased vascular permeability, and entry of inflammatory cells into the injury site. Prostaglandins are thought to be involved in these processes.

How Not to Treat Acute Inflammation

  1. If you’re experiencing acute inflammation – the type that occurs after an injury, after surgery, or after a muscle-fiber damaging workout – avoid taking any NSAIDS. While they’ll help quell the pain, they impede the healing process and in the case of muscles, they may well impede further growth. Granted, the occasional use of NSAIDS won’t likely pose much of a problem, but if you take them regularly, the odds are high that you’re impeding muscle growth.
  2. Reconsider icing sore muscles. The initial thinking was that it was safe to ice a muscle because there was no need for immune cells to get all angried up when the injury was internal and there was no possibility of infection. The trouble is, that’s short sighted. Granted, icing will help with pain, but since we now know that inflammation is necessary for muscles to grow bigger and stronger, icing is likely counterproductive.

Instead, Treat Acute Inflammation Like This…

  1. If you’re hurting from acute inflammation caused by an injury or you’re debilitated from a brutal workout and you simply can’t handle it, consider using acetaminophen. While it does exhibit some anti-inflammatory effects, it’s more of an analgesic.
  2. If pain persists after a couple of days, take any NSAID you feel is necessary, or, preferably, take appropriate doses of Curcumin. Curcumin is a potent anti-inflammatory and it blocks a host of inflammatory compounds by a certain reasonable percentage, as opposed to blocking one particular inflammatory compound by 100 percent. As an example of the latter, the prescription painkiller Vioxx shuts down COX-2 production completely and got lots of bad press for causing all those pesky heart attacks.

VIDEO: Tendinopathy (Tendon Injury)

Tendinopathy (tendon injuries) can develop in any tendon of the body.

Typically, tendon injuries occur in three areas:

  • musculotendinous junction (where the tendon joins the muscle)
  • mid-tendon (non-insertional tendinopathy)
  • tendon insertion (eg into bone)

Non-insertional tendinopathies tends to be caused by a cumulative microtrauma from repetitive overloading eg overtraining.

 

What is a Tendon Injury?

Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually, it is the result of repetitive tendon overloading. Health professionals may use different terms to describe a tendon injury. You may hear:

Tendinitis (or Tendonitis): This actually means “inflammation of the tendon,” but inflammation is actually normal tendon healing response which can cause some tendon pain. This is known as the reactive phase and is a good tendon healing response.

The problem really occurs when you healing rate is less than your injury rate – known as tendon dysrepair – which is when tendinopathies can quickly deteriorate into the degenerative (cell death) phase. This is characterized by collagen degeneration in the tendon due to repetitive overloading. These tendinopathies therefore do not respond well to anti-inflammatory treatments and are best treated with functional rehabilitation. The best results occur with early diagnosis and intervention.

What Causes a Tendon Injury?

Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or ageing. Anyone can have a tendon injury, but people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon.

Your tendons are designed to withstand high, repetitive loading, however, on occasions, when the load being applied to the tendon is too great for the tendon to withstand, the tendon begins to become stressed.

When tendons become stressed, they sustain small micro tears, which encourage inflammatory chemicals and swelling, which can quickly heal if managed appropriately.

However, if the load is continually applied to the tendon, these lesions occurring in the tendon can exceed the rate of repair. The damage will progressively become worse, causing pain and dysfunction. The result is a tendinopathy or tendinosis.

Researchers current opinion implicates the cumulative microtrauma associated with high tensile and compressive forces generated during sport or an activity causes a tendinopathy.

For example, in explosive jumping movements, forces delivered to the patellar tendon can be eight times your body weight. Cumulative micro trauma appears to exceed the tendon’s capacity to heal and remodel.

 

What are the Symptoms of Tendinopathy?

Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.

  • The pain may get worse when you use the tendon.
  • You may have more pain and stiffness during the night or when you get up in the morning.
  • The area may be tender, red, warm, or swollen if there is inflammation.
  • You may notice a crunchy sound or feeling when you use the tendon.

The symptoms of a tendon injury can be a lot like those caused by bursitis.

Tendinopathy Phases

The inability of your tendon to adapt to the load quickly enough causes tendon to progress through four phases of tendon injury. While it is healthy for normal tissue adaptation during phase one, further progression can lead to tendon cell death and subsequent tendon rupture.

1. Reactive Tendinopathy

  • Normal tissue adaptation phase
  • Prognosis: Excellent. Normal Recovery!

2. Tendon Dysrepair

  • Injury rate > Repair rate
  • Prognosis: Good. Tissue is attempting to heal.
  • It is vital that you prevent deterioration and progression to permanent cell death (phase 3).

3. Degenerative Tendinopathy

  • Cell death occurs
  • Poor Prognosis – Tendon cells are giving up!

4. Tendon Tear or Rupture

  • Catastrophic tissue breakdown
  • Loss of function.
  • Prognosis: very poor.
  • Surgery is often the only option.

It is very important to have your tendinopathy professionally assessed to identify it’s injury phase. Identifying your tendinopathy phase is also vital to direct your most effective treatment, since certain modalities or exercises should only be applied or undertaken in specific tendon healing phases.

How is a Tendon Injury Diagnosed?

To diagnose a tendon injury, your physiotherapist will ask questions about your past health, your symptoms and exercise regime. They’ll then do a physical examination to confirm the diagnosis. If your symptoms are severe or you do not improve with early treatment, specific diagnostic tests may be requested, such as an ultrasound scan or MRI.

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VIDEO: Simple guide to Tendons for Armwrestlers & Everyone else

Tendons

Tendons are situated between bone and muscles and are bright white in colour, their fibro-elastic composition gives them the strength require to transmit large mechanical forces. Each muscle has two tendons, one proximally and one distally.

Tendons are connective tissue, group of tissues in the body that maintain the form of the body and its organs and provide cohesion and internal support. The connective tissues include several types of fibrous tissue that vary only in their density and cellularity, as well as the more specialized and recognizable variants—bone, ligaments, tendons, cartilage, and adipose(fat) tissue.

The dry weight of each wall of tendons is made up of more than 95% of collagen. The ends of tendons, which are the most solid parts, are composed almost exclusively of collagen, up to 99%. Our tendons’ properties and functions are directly related to the architecture and quality of the collagen fibres. The collagen portion is made up of 97–98% type I collagen, with small amounts of other types of collagen

The structures surrounding the tendon can be split into 5 subcategories. The main aim of these structures is to reduce friction and enable the tendon to glide smoothly. This is an important factor for ensuring the transitions of the force is at its most efficient.

Tendon functions

The tendons’ main role is to transmit forces from the muscle to the bone and absorbs external forces to prevent injury to the muscle. As the tendon runs from a very compliant tissue (the muscle) to a ridged stiff one (the bone), this role can become very difficult, this can result in strain concentrated at the site of merging tissues. This can be a common site of injury.

The make up of the tendon is now not thought to be the same throughout, research has discovered that the tendon itself may be more ridged in some parts and more compliant and elastic in others to overcome this concentration of strain and risk of injury. Each tendon will differ throughout the body depending on the rate in which they are strained. The behaviour of the collagen within the tendon depends on the intramolecular types, quantity and bond.

Tendon injuries

Collagen contributes to keep the structure and strength of tendons. When collagen breaks down, small tears appear in the tendon, weakening it and causing pain. Tendinitis notably affects those who perform repetitive tasks in their jobs, sports or daily activities. Another example of a disease related to tendons is bursitis. Bursitis is the swelling of the bursa, a small fluid-filled sac that allows muscles to glide easily over other muscles as well as bones. When you hurt a joint or tendon or use it excessively, the bursa may swell, causing pain, redness and a burning sensation.

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