How to look after your tendons to
Catharine Bainbridge - Elite Myotherapist
I recently had a client come to me with severe knee pain.
Anyone that has had a knee issue in the past will know that knee pain can come from a variety of issues including: trigger point referrals from surrounding muscles, ligament damage, tendon damage, meniscus damage, biomechanical issues/weaknesses, back problems, foot problems, cartilage issues, arthritis and problems with the patella (knee cap) tracking properly. Fortunately enough I had recently participated in a workshop that would result in the clients diagnosis being relatively quick and easy to detect and manage.
Currently a lot of knee pain is diagnosed as a tendinopathy especially if the knee pain is around the patella tendon in general or if a scan has indicated that the patella tendon is damage/being overloaded. The workshop I attended was run by Ebonie Rio who together with Jill Cook has been studying tendons for many years and are changing some of the literature that a lot of therapists had previously been taught during their tertiary studies.
Some of the rules for diagnosis of a Tendinopathy that Jill/Ebonie have developed to diagnose tendinosis include the following:
-A tendon pathology on imaging does not change the clinical diagnosis. It is not an indicator of pain for the patient regardless of what the tendon looks like. A lot of athletes have pathological patellar tendons and have no knee pain/issues that they are aware of.
-Loading up the tendon in an isometric exercise (putting it under strain with weight) under controlled conditions by your therapist may REDUCE knee pain.
-The client can point to the site of pain on the tendon WITH ONE FINGER. The pain is localised and does not refer or spread regardless of time or load.
-For a patient with a patella tendinopathy in the knee, the therapist can perform a decline squat test. The pain should come on at the start/initiation of the squat not at mid to end range.
-If the patella tendon is overloaded the client often feels worse on a pain scale the day after the activity in their patella tendon.
Using the above criteria I was able to diagnose a patella tendon issue in my client. The week between treatments for my client involved home exercises of isometric holds in a decline squatting position, (body weight only-the amount of weight a client can handle for rehab will depend on the pain levels the day after exercise) releasing the surrounding quadriceps muscles with foam rollers and spiky balls and avoiding activities such as basketball that involved a lot of squatting/jumping until the tendon was stronger. There has only been 2 weeks so far since our first myotherapy treatment and already my clients pain levels have decreased 2-3 points on a pain scale and is able to manage his knee pain appropriately.
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