Tendons, which are strong, rope-like tissues, contain collagen protein and connect the muscles to the bones. When the collagen in a tendon breaks down, the disease is known as Tendinopathy or tendinosis. This disease causes pain and leads to lesser flexibility and excursion of the tendons.
Tendinopathy can occur in any tendon in the human body. However, the more common ones are:
● Rotator cuff tendons
● Common extensor tendon ( Tennis elbow)
● Common flexor tendon ( Golfer’s elbow)
● Hamstring tendons
● Patellar tendon
● Achilles Tendon
The most common cause of this overuse condition is mismanagement between the loads and the recovery of the tendon from these loads. Tendinopathy can also occur due to ageing and a lack of muscle strength. It is not completely clear as to what causes the pain in the tendinopathic tendon. Combination of local and distant causes with contribution from central mechanisms plays a role. Existing chronic diseases, supplements, medication play a role in the pathogenesis of tendinopathy and the resolution of the symptoms.
Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids were earlier advised to treat tendinopathy as a first line treatment. With better understanding of the condition, several other options are now becoming available.
Usually, home-based treatments along with activity modification, physical therapy works the best for the treatment of tendinopathy. However, in severe and resistant cases, the patient might need other treatments such as biological therapies and even surgery.
Home treatment involves modifying the exercises physical activity and exercises.
Physical therapy for tendinopathy includes various techniques depending on the patient’s condition. But the two most common physical therapies are:
● Soft tissue release and deep transverse friction massage that helps in stimulating cell activity and generating new collagen fibres along with releasing the tight soft tissue structures.
● Combinations of Isometric, concentric and eccentric exercises.
The biological therapy therapy procedures performed by Dr Khullar include Platelet rich plasma injections, Autologous blood injection, and Prolotherapy. Newer methods based on Stem cells still lack sufficient evidence for the benefit and hence have a very limited role in Dr Khullar’s practice.
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