NCTV Episode 56

Continuing with the series of bitesize health tip videos which can be found here on my YouTube Channel, this episode, includes:-

  • Risk factors to avoid
  • Commonly associated conditions
  • How to reduce and prevent back pain
  • How to speed up your recovery
  • When to seek medical advice


If you’d prefer to read the content within, rather than watch the video, then feel free to read the transcript, as follows:-

Hello and welcome to NCTV Episode 56 on the topic of tendon problems. Another all-encompassing word for tendon problems that fail to heal is tendinopathy…or…just plain “ouch” if you happen to suffer from it.

About Tendinopathy: A tendon is a fibrous band of tissue that connects a muscle to a bone. There are many names for describing when tendon tissue is inflamed, injured or damaged, including tendonitis, tendinosis, and tendinopathy as well tenosynovitis, and tendon tear or rupture.

Essentially, the umbrella term tendinopathy is a painful condition occurring in and around tendons in response to overuse. Aging and lack of muscle tone can also play a role in its development.

It’s typically seen in the elbows, the hamstring, patella (or kneecap) and the shoulder, particularly the rotator cuff.

The symptoms of tendinopathy can include: pain, swelling, stiffness and restricted mobility at the affected joint and muscle weakness.

10 common causes of tendinopathy include:

  1. Overuse of the tendons by repetitive actions
  2. Any sporting activity that requires lots of jumping and running
  3. Running on hard surfaces
  4. Poor sporting technique or inappropriate sporting equipment, such as a tennis racquet that’s too heavy
  5. Lifting weights that are too heavy
  6. Neglecting to warm up properly before doing sport or exercise
  7. Not taking enough rest time between training sessions to allow full recovery
  8. Exercising in cold temperatures
  9. Awkward positions that are maintained for a long time
  10. Being obese, which puts excessive pressure on the tendons of the legs.

Ways to manage mild cases of tendonitis at home include:

  • Stop whatever activity triggered the pain.
  • Rest the area! Trying to ‘work through’ the pain will only make your symptoms worse and delay healing.
  • As symptoms lessen, use the area as normally as possible because total immobilisation or rest can make the problem worse.
  • Regularly apply ice packs to the affected area, as needed, in the first few days to help reduce swelling and pain.

The time to seek medical advice for tendinopathy is if it’s severe or persistent and if your symptoms haven’t improved after a few weeks of home treatment.

To reduce your risk of tendinopathy here are a few things you can do:

  • Lose excess body fat, if necessary.
  • Make sure to thoroughly warm up and cool down before and after exercising.
  • Make sure you maintain good form when participating in your chosen sport or exercise and resist the urge to push yourself too far too fast.
  • Reduce the risk of overtraining by participating in a range of exercises and sports.
  • Wear footwear appropriate to your sport.
  • Use professionally fitted shoe inserts if you have bow legs or flat feet for example.
  • Rearrange your workstation or daily work schedule to avoid long periods of the same manual activity (such as typing on a keyboard or using a hammer).

Where to get help: Obviously a physical therapist such as an osteopath or physio. Also a podiatrist when appropriate and not to mention, your doctor.

When it comes to treatment, something to be mindful of; research now suggests that there is growing evidence that NSAID anti-inflammatories may actually slow down the recovery process.

Additionally, it’s been shown that corticosteroids provide temporary pain relief but do not appear to have any established longer-term benefit.

With that in mind, physical therapy remains a great first line of treatment and reviews suggest that eccentric strengthening exercises are a good form of physical therapy to be performed for up to twelve weeks. Initially the aim is to reduce the load on the tendon and to reduce the pain. Then it’s about restoring the strength and function of the tendon gradually to preserve its long-term health.

Note that it’s important to still be lightly active to maintain your strength and overall health. As an example, it’s worth considering low-impact activities, such as swimming to aid in your recovery.

So what are eccentric exercises? If you imagine you’re holding a dumbbell ready to do a biceps curl, instead of bringing your wrist to your shoulder which is called a concentric exercise (where you overcome the force), you slowly allow the weight to overcome your force which causes your muscles to lengthen while they contract. Other examples of this may be squats for your knees or a tip-toe exercise, lowering your heel off the edge of a step, for your Achilles.

You can also try the RICE method, which is often very effective for tendon injuries and involves:

Rest. Try to stay off the affected body part as much as you can.
Ice. Wrap an ice pack in a light towel and hold it to the affected area for 10 minutes.
Compress. Wrap the area in an elastic bandage, making sure it’s not too tight.
And Elevate. Keep the affected area raised on a pillow or other device. This can help to reduce any swelling.

Finally, on the topic of treatment, as a last port of call, if after a combination of home treatment and physical therapy your symptoms aren’t showing any signs of improvement, it may be time to consider tendon repair surgery.

How can you prevent tendinopathy? Well here are 5 ways:-

  1. Vary your exercises.
  2. Include warm-up and cool-down exercises and stretches in your routine. As a general rule, a good warm-up is five minutes for every 30 minutes of planned exercise.
  3. Try to prevent repetitive use of the same joint, resting it when possible.
  4. Make sure to wear appropriate footwear or other equipment,
  5. and slowly increase your exercise load as a dramatic increase in tendon use can pose a significant risk for overuse tendinopathy.

That’s it for this week’s bitesize bit to help your health flourish and I will see you next time, bye bye for now.