Tendonitis is incorrectly used to describe chronic or repetitive strain tendon injuries. In order for an injury to be called tendonitis there has to be presence of active inflammation. Anything with an “itis” means inflammation. There are very few to no inflammatory cells present in repetitive strain tendon injuries.
The correct term to describe repetitive tendon injuries to the Patellar Tendon, Achilles Tendon and Quadriceps is tendinosis or tendinopathy. Anything ending in an “osis” means degenerative changes. Tendinosis is caused primarily by chronic overuse of the tendon and by not giving the tendon enough time to rest and heal.
The Difference Between Tendonitis And Tendinosis [Click To Tweet]
Symptoms and Information about Tendonitis And Tendinosis [Click To Tweet]
Tendon Injury: Topic Overview of Tendonitis and Tendinosis [Click To Tweet]
Hey guys, this is Manu Kalia, physical therapist and Ayurveda herbalist. So today’s video is a little bit different. It’s not an exercise or mobilization technique that I’m showing you. I wanted to go over something really important and that’s a major misunderstanding regarding tendon injuries. So the common term that most people know about repetitive tendon injuries or repetitive strength-type injuries to the tendons is tendonitis. So the term tendonitis, which is more popular, and I know even in some of my old videos, for example when I’m talking about patellar tendonitis or Achilles tendonitis, I’ve said the word tendonitis, but that’s just so it’s easier for most people to understand and because most people are familiar with that term.
But the correct term is actually, for those types of injuries, is tendinosis. So tendonitis, though it’s used more commonly, is incorrect, and the reason is because for repetitive strain injuries like patellar tendon issues for runners or athletes or quadriceps tendon issues of volleyball players or people who are doing a lot of activities that require jumping or Achilles-tendonitis-type problems, in a lot of studies I’ve seen this, when they really looked at it, there’s no actual inflammation going on at that tendon. And remember, and I mentioned this in some of my old videos, acute inflammation that takes place after an initial injury is a normal response of the body. It’s not a bad thing. It needs to happen for the tissue to heal properly. So first of all, regarding the tendon, there is no inflammation and they found that there are no inflammatory cells present in these injuries, and a lot of these injuries are very chronic problems. So remember, anything that has “itis” at the end of it means inflammation.
And now we look at tendinosis, which is actually the correct term for those types of problems, which are even caused more due to repetitive strain. Yeah, you can have a quick movement or an injury where is a forceful movement taken or load going to that tendon which causes micro-tears or ruptures or even a partial or complete tear – that’s something different. And in initial stages you might have an inflammatory process that takes place, but for chronic problems that come on over time the correct term is tendinosis. Anything that has “osis” at the end of it is degeneration, which means that it’s due to excessive wear and tear. The body basically just can’t keep up with the repair process and so the load that’s being placed on it, stress that’s being placed on that tendon, this just can’t keep up and heal that tendon.
So that’s a major distinction between these problems. And that goes for all sorts of repetitive strain tendon-type injuries, and that’s why use of anti-inflammatories or, in my view, ice and all those things, is not helpful for these injuries. It’s not going to take care of that problem.
So the normal tissue—tendons remember are made up collagen, collagen is protein—and normal tissue, normal alignment of the collagen and tissue is in a parallel fashion. They’re parallel bundles that are laid out, which give the tendon its tensile strength. So, normal fashion, they are laid out in an organized fashion, but once you start having these degenerative problems or degeneration and wear and tear of that tendon, and like we said there are no inflammatory cells present in tendon-type injuries, tendinosis, or tendinopathy is another term that’s used for that, so the collagen fibers are laid out in a disorganized manner. They’re not laid out in parallel bundles. They’re kind of jumbled and haphazardly laid out. So the normal healing process didn’t takes place properly. As the collagen was being laid down, as repair was taking place, it kind of went off and it gets laid down in a jumbled, disorganized fashion so that doesn’t give it it’s proper tensile strength to that tendon.
So you will see things like weakness and you’ll see things like swelling. You’ll see thickening of that tendon just because things are not organized and laid down properly. They don’t move properly. A lot of studies have shown there is more vascularity, so there are more blood vessels that are formed, but again they are formed in a haphazard manner, not laid down properly again. So they’re not necessarily helping the tendon in terms of the healing process.
So like I said, the cross-linking that’s taking place, which is that jumbled formation, they increase vascularity and there’s even more ground substance, which is the substance that’s surrounding the cells which supports the cells. So all these things kind of give it that thickened, swollen-type appearance to a lot of those tendons. So, one, they’re going to be thickened and swollen, they’re going to be weak, and of course you’re going to have pain and you might have some tightness along that tissue too.
So think about it from this perspective when you’re looking at treating these problems. So as I said, it’s not an inflammation type of problem. That’s incorrect. The understanding that most people have, “ice it and take anti-inflammatories, it’s going to take care of the problem,” it’s not going to take care of the problem. So it’s more of a degeneration that’s going on and so we need to do other things to get it better. So as in a lot of my other videos, you’ve seen cross friction massage techniques that I have done, heat application, and internally you’ve got to do things to help the system heal too, and of course backing off on the aggravating activity that’s taking place.
So I hope it kind of gives you an understanding of what’s going on, and we’ll keep talking more about shooting videos on treatment options. You’ve seen some of the treatments, and I’ll go more in-depth into some of the external factors and internal “within the body” factors that are taking place and causing these problems, why some people are more susceptible to those issues than others. Also, stay tuned, we’ve got our program coming up pretty soon—very excited—and it’s going to be awesome. For those of you guys who are runners and athletes, you’re going to love it, and we’re in the process, we’re building it up, and we’re going to get the editing and those things done pretty soon and it’s going to be out. And if you have any questions, leave a comment, and make sure you subscribe to the channel and click on the link below to check out the site. Thanks, guys.