14 Apr How to Treat a Tendon Injury
What is a tendon injury?
Tendons are strong, cord-like structures that anchor the muscles of the leg, foot and ankle to the bone. Tendonitis is an inflammation surrounding a tendon. Tendon injuries most likely occur due to gradual wear and tear to the tendon from overloading it while walking/ running/ jumping and doing repetitive movements. Your body can’t cope with the load you put on your tendons, leading to injury. Inactivity also causes tendon injury. How? If you’ve been inactive for a long time and decide to start exercising again, you increase your risk of getting injured if your body can’t cope. This may result in acute overloading i.e. reactive tendinopathy. You’ll probably experience symptoms of pain at the start and towards the end of activity or next day post activity i.e. tendon flare ups. The injury can worsen through continuance of overloading. This leads to tendon disrepair and eventually degeneration.
Tendons can tear; however, this rarely happens if you have healthy tendons. It’s more you’ll see muscle tears or avulsions fractures. Unhealthy tendons may have an increased risk of tearing.
- Partial rupture, while relatively uncommon is where a portion of the tendon is torn.
- Full rupture/ tear is where a portion of the tendon is completely torn.
How is a tendon injury diagnosed?
Our podiatrists will look at the probable cause(s) for why and how this injury occurred, taking into account factors relating to biomechanics, muscles, activities, ground surface, age and systemics. They may also use imaging like an ultrasound and/or MRI.
A partial tear is characterised by a sudden onset of pain, localised tenderness surrounding the tendon and loss of tendon function relative to the size of tear.
For a full tear, there is a total loss of tendon function along with acute pain. However, pain generally subsides quickly due to damage of little nerve fibres surrounding the torn tendon, making it unable to send pain signals to the brain.
How can Podiatrists treat a tendon injury?
- Understand you as a person – not just your injury. Once we get to know the real you, we can set shared goals and make a plan.
- Manage pain and inflammation, if present.
- Refer you for surgery if a full tear has occurred. Depending on your decision, we will see you post-surgery or post-consultation with a specialist for rehabilitation.
- Educate you on your injury and the factors affecting your recovery.
- Help you with control load depending on anatomical location and severity of the tear.
- Orthoses (insoles to control your foot, ankle and lower limb posture)
- Footwear (assist with support and stability of your foot and ankle)
- Modify activities (re-centre your capacity to the amount and type of activity you do)
- CAM Boot (if required to prevent movement and immobilise the tendon to allow healing)
- Aim to get you stronger than your pre-injury self through rehabilitation.
- Get you moving as early as possible through exercise therapy. Start slow with gentle exercises progressing to more challenging and functional strength exercises to ensure a safe return to activity
- Use Radial Pressure Wave Therapy (Shockwave) to stimulate tendon healing and reduce pain response
- Try dry needling, massage therapy and foot mobilisation as short-term modalities to reduce pain response and improve dysfunction
How to minimise re-injuring your tendon
- Keep on moving
- Be mindful of the amount of loading you’re doing by following a loading program
- Listen to your body – flare ups can happen
- Invest in yourself
- Keep up the functional strength training exercises
- Change your shoes regularly
- Vary your exercise routine to keep your workouts fun and challenging
- Check in with your podiatrist regularly at least 6 monthly or yearly to stay healthy and injury-free