If you google the term ‘tendinitis treatment’ one of the commonest pieces of advice is to ‘stretch’ the affected tendon and surrounding muscles. This might sound good in theory but can actually be detrimental in getting your tendon better. Tendinitis is now better termed ‘tendinopathy’ given that research has now shown there is virtually a nil inflammatory process taking place in most cases.
Tendons are made of collagenous tissue within an extra-cellular matrix.They essentially join muscles to our bones but also play an important part is transferring load. Research has shown that tendons can be subjected to two main types of loads – tensile and compressive.
Tendons are subjected to tensile loads every day and they can withstand 6-8 times our body weight of load. For example, a runner’s Achilles tendon would be subjected to more tensile load if they increased their mileage.
Compressive loads have been shown to also aggravate tendons. A compressive load on the Achilles tendon example would be whereby the foot and ankle is in a dorsiflexed or upwards position and the tendon is in a lengthened position e.g. during a squat position. An achilles tendon would be placed under a compressive load if one was to do a calf stretch against a wall. This stretch is commonly advised for Achilles tendinitis and may actually provoke an already aggravated tendon.
Other commonly prescribed treatments may not always be the best for reactive tendons; eccentric exercises are also commonly prescribed for this condition whereby the heel is dropped down over a stair, again applying a compressive load to the tendon.
Massage to a reactive tendon may also aggravate it further. Better treatments particularly in the reactive phase of tendinopathy would be massage to the muscle belly or surrounding muscles and/or isometric loading exercises. There are other treatment adjuncts to these that may also be helpful for tendinopathy.
This is why it is important to see a qualified foot professional to determine the best course of treatment for your tendinopathy.