It is possible to sustain a tendon injury through various activities from work to contact sports, and onset can be gradual or sudden. Tendons are found throughout the body and attach muscle to bone. Most tendon injuries occur close to a joint with the most commonly affected injuries being the shoulder, elbow, ankle, knee and hand. These injuries can be extremely painful and debilitating and vary in degree of severity from tendonitis to complete rupture.
Tendonitis is a term used for inflammation of the tendon or surrounding area due to wear and tear from repetitive use (i.e., running) or sudden, sharp movements (i.e., lifting, jumping) that can overload a joint and causing small tears in the tendon.
If you have a tendon injury, you may experience increased pain with movement, stiffness, weakness, swelling and a cracking sensation called crepitus in the affected area. Pain may be point specific or may radiate from the joint and increase at night or first thing in the morning. If you feel a tightness on the bottom of your foot that gets worse with use, you may be experiencing plantar fasciitis. The Achilles tendon is another tendon in the foot which can tear or develop Achilles tendonitis. When it tears the first symptom is immediate pain and dysfunction. When the bicep tendon is torn, you feel immediate sharp pain and the muscle will look deformed in the upper arm.
Current management for tendon healing with tendonitis includes:
Tendon repair surgery is required when the tendon has pulled away from the bone as a result of a traumatic injury or laceration. The tendon is reattached to the bone or end-to-end, and splinting/immobilization are required to allow time for tendon healing.
Occasionally a tendon graft is required to reconnect the tendon when it has retracted from the bone. Alternatively, a tendon transfer may be required, which involves relocating a tendon from an unaffected area to the affected area to restore functional use. The stages of tendon healing takes time but occurs in 3 stages.
A repaired tendon is weakest from 7-10 days post-op. The tendon strength increases moderately by 21-28 days post-op and max strength is reached at 6 months post-op. Final tendon strength is about 2/3 the pre-injury tendon strength, especially with older individuals.
Early mobilization allows for improved range of motion (ROM), but can decrease the strength of the tendon repair. This is why undergoing Occupational or Physical Therapy treatment is an important part of tendon healing.
If an individual progresses too quickly past post-surgical guidelines the tendon healing process can be impaired. One of the biggest concerns with tendon healing is increased scarring which prevents movement, loss of joint mobility, stiffness and possible tendon re-injury. The tendon healing process lasts 12 weeks pending injury.
Patients will require physical therapy to regain motion and strength while safeguarding the tendon repair. Therapy will focus on decreasing scarring to promote increased strength and mobility of the repaired tendon. The sooner the tendon repair is performed, the greater the likelihood of a successful operation with positive recovery outcomes. Once healed, yoga is a great alternative exercise that has a very low impact on the body.
To schedule an appointment with a JOI Orthopaedic Specialist, please call 904-JOI-2000, schedule online or click below.