TENDON PAIN

Tendonitis, tendonosis, tendonothapthy?


These are common conditions in the shoulder, elbow, wrist, hip, knee and ankle. Tendon injuries usually are due to overload. This might be too much load for too long or it might be a change in what load your tendon is used to (eg: sudden change in exercise routine).


Microdamage in the tendon occurs due to the overload stress with resulting local inflammation and swelling. Managed early and properly tendons will often settle quickly. Remember though, tendons are tough and take a long time to complain to the point where we notice them. In the same way they can take a long time to settle down after flaring up. They need to be managed carefully through this period.


In addition to examining the tendon and joint close to it, proper assessment should include examination of the neck or back (depending on the tendon) to define any nerve contribution to the tendon problem. Subsequent treatment may involve mobilization of the spine as well as local treatment of the tendon.



While they don't like being overloaded, they love being loaded properly, so exercises which include progressive isometric and eccentic programs are vital. Again, these exercises need to be advised and managed correctly!

SIDE HIP PAIN

July 1, 2025
Pain on the side of the hip from bursitis or gluteal tendon inflammation is an annoying problem often more so at night because lying on it frequently disturbs people’s sleep. It is a reasonably common problem for me to see. Tendons and bursae degenerate as we age and weakness in hip musculature can be a cause. But it can happen to anyone. Guided steroid injections can help, but most people respond well to soft tissue manipulation. The lower back should definitely be assessed and (usually) treated manually as related spinal joint stiffness frequently contributes to the issue. The hip joint should also be assessed and treated if necessary. Exercises can be helpful but need to match the pathology so an Ultrasound image might be needed give a diagnosis.

IRONMAN

June 1, 2025
Interstate visitor Client D came in two days before the Melbourne Ironman. Despite treatment interstate he had persisting leg soreness which had stopped him running for a week and had serious doubts on finishing, let alone doing well enough to earn him what he entered for: a qualifying position in the Hawaiian Ironman. He had some back joint stiffness and lateral hamstring trigger point muscle spasm and after loosening these up he felt better. However running a full marathon after the 3.8 kilometre swim and 180 kilometre cycle would be a massive test! The news post race was that he had got though the event and even with a puncture on the cycle grabbed a spot in Hawaii!  Well done to him! (And a bit to me too!)