A theory has recently been proposed on the pathology of tendinopathy (injury to a tendon), which has been derived from tissue and animal studies.
The theory proposes a new model consisting of a continuum of three stages: reactive tendinopathy, tendon dysrepair (failed healing) and degenerative tendinopathy. With this model, rather than three separate stages, the injured tendon can exist along the three stages. A reactive tendon is when there is a non-inflammatory response to load due to a sudden increase in activity. As the tendon continues to be over loaded, the tendon progresses to the tendon dysrepair phase where the tissues of the tendon start to separate and become disorganized. At degenerative tendinopathy, cell death occurs at the tendon, and if damage to the tendon continues, a rupture may occur with a high load. Throughout these stages, the tendon has the ability to heal and return to normal tendon, however the ability to repair itself decreases as damage to the tendon reaches degenerative tendinopathy. While rest may be a logical way to allow for healing of the tendon, previous studies have shown that unloading the tendon causes similar changes to an overloaded tendon resulting in a decrease in integrity of the tendon as well.
With injured tendons along this continuum, physical therapists can help identify the proper loads for the tendon to begin reversing the pathology. By providing the tendon the proper exercises, the tendon can respond appropriately and begin the recovery process.
Speak to your PT Specialist at AmeriCare Physical Therapy and learn ways to treat your tendon related injuries.
