COMMUNITY: Think it’s tendinitis? Consider tendinosis

Editor's note: Cody Scharf is the owner of Thrive Spine and Sport, a chiropractic and soft tissue clinic focusing on sport and overuse injuries in Cedar Rapids. Scharf is a graduate of Palmer College of Chiropractic and certified through Integrative Diagnosis for the diagnosis and treatment of soft tissue injuries.

By Cody Scharf, community contributor

Does this sound familiar?

You develop pain, and it's getting worse. You pull out your computer and search for what's wrong. The search reveals 'tendinitis.”

Looking at the treatment options, you decide to take a couple weeks off, ice twice a day, stretch as often as you can and take pain relievers when needed.

Things are going great, the pain has disappeared and you decide to get back to regular activity. You start your warm up. You begin to play or run, then uh-oh, the pain is back.

It hasn't left. Now what do you do? Cortisone shot? Surgery?

Why did the pain return? The answer is simple. The diagnosis and treatment were wrong.

What we are finding now is that most cases of tendinitis are misdiagnosed and are actually tendinosis. While tendinitis is believed to be an inflammatory process, tendinosis is a degenerative one.

With return of activity and lack of proper recovery, we often see overuse of muscles and joints commonly used in that activity. With overuse, tendons and muscles become weak and degenerate. Once the muscles and structures are weak, adhesion will form to try to stabilize the area. This also alters joint motion and leads to further weakness and pain. If left untreated, this can lead to torn muscles, tendons and ligaments. Rest, ice and stretching do nothing to repair damage to injured soft tissue.

Treatment of tendinosis takes a different approach. Try these four steps:

- Manual therapy. Adhesion is the most common result of overuse. To remove adhesion, you need therapy from someone certified to treat the condition.

- Eccentric exercise. When a tendon or ligament is degenerated, rest will not fix it. It needs to be regenerated and strengthened. Eccentric exercise does this by helping improve blood flow into the origin and insertion points of muscles where degeneration is common.

- Nutrition. Proper nutrition is vital. Combining that with increased blood flow from eccentric exercise increases nutrients to the area needing repair. Supplementing with vitamin C can help to repair collagen in tendons and ligaments.

- Get a brace. Using a brace reduces stress on the injured area and allows treatment to be more effective and can help speed up recovery time.

Recovery time depends on how long symptoms have been present and how much damage has been done to the soft tissue.

- For more information, email Scharf at cody.scharf@gmail.com or visit www.thrivespineandsport.com.