Tendonitis is a common musculoskeletal condition characterized by pain and tenderness, often resulting from overuse or repetitive strain. This condition involves the irritation of a tendon, the thick, fibrous cord that connects muscle to bone, causing stiffness and discomfort near a joint. Many people seek conservative, non-invasive approaches to manage their symptoms and address the underlying cause. This article explores how a chiropractor can help treat tendonitis by focusing on biomechanics, joint function, and soft tissue health.
Understanding Tendonitis
Tendonitis is the inflammation or irritation of a tendon, frequently caused by repetitive motion or a sudden increase in activity level. Tendons exist throughout the body, transferring force from muscle contraction to movement of the skeletal system. Common sites include the elbow (tennis or golfer’s elbow), the shoulder (rotator cuff), the knee (patellar tendonitis), and the ankle (Achilles tendonitis).
The underlying issue is often not just an isolated tendon problem, but a response to poor biomechanics or structural imbalance that creates undue stress on the tissue. Repetitive strain from activities like gardening, typing, or specific sports can overload the tendon, leading to micro-tears and an inflammatory response. Addressing the overall movement pattern, rather than just the painful spot, is important for preventing the condition from becoming chronic.
Assessment and Diagnosis
A chiropractor’s approach to tendonitis begins with a detailed assessment to identify the root cause of the strain, which often originates far from the site of pain. The initial consultation includes a comprehensive health history, focusing on the onset, duration, and aggravating factors related to the pain. This helps the chiropractor understand the patient’s occupational and recreational activities that may contribute to the overuse injury.
The physical examination involves palpation of the affected tendon to pinpoint the area of maximum tenderness and mild swelling. Range of motion testing is performed on the affected joint and surrounding structures to look for limitations or joint restrictions that could be placing additional strain on the tendon. Orthopedic stress tests, such as resisted movements, are used to confirm the diagnosis and distinguish the issue from other conditions like joint subluxation or nerve entrapment.
Specific Chiropractic Treatment Methods
Chiropractic treatment for tendonitis combines manual therapies and passive modalities aimed at reducing local tissue tension and improving overall joint mechanics. A common approach involves soft tissue therapy, which directly addresses the injured tendon and surrounding musculature.
Soft Tissue Techniques
Techniques like Instrument-Assisted Soft Tissue Mobilization (IASTM), such as the Graston technique, utilize specialized tools to effectively break down scar tissue and fascial restrictions that may limit tendon mobility and healing. Another method is Active Release Technique (ART), where the chiropractor applies tension to the soft tissue while the patient actively moves the joint through a specific range of motion. These soft tissue techniques promote circulation and accelerate the natural healing process by increasing blood flow to the affected area.
Joint Manipulation and Adjunctive Therapies
Joint manipulation, or chiropractic adjustments, is used to correct misalignments in the joints supporting the injured area, such as the ankle or shoulder. By restoring proper movement in these adjacent joints, the overall mechanical stress on the injured tendon is reduced. Adjunctive therapies are often incorporated into the treatment plan. Therapeutic modalities such as cold laser therapy or therapeutic ultrasound may be used to manage inflammation and stimulate cellular repair processes within the tendon. Cryotherapy, or the application of ice, may also be recommended to reduce pain and local swelling.
Active Recovery and Prevention
The patient’s active participation is an important factor for successful long-term recovery and prevention of future episodes of tendonitis. Chiropractors typically prescribe therapeutic exercises that focus on strengthening the muscles surrounding the affected tendon and improving joint stability. Eccentric loading protocols, which involve strengthening the muscle as it lengthens, are commonly recommended as a specific rehabilitation method for various types of tendon issues.
Guidance on stretching routines is also provided to improve flexibility and reduce chronic tension in the muscle-tendon unit. The chiropractor will often provide ergonomic and lifestyle modifications, such as advising on proper posture at a workstation or correcting technique during a sport or physical activity. These adjustments are important for reducing repetitive strain and preventing the recurrence of the injury.
In cases where the condition is severe, chronic, or does not respond to conservative care, a chiropractor will recognize the limits of their scope of practice. They may recommend a referral to an orthopedic specialist or physical therapist for further diagnostic imaging or advanced medical interventions. This collaborative approach ensures that the patient receives the most appropriate level of care, especially if a more serious issue, such as a significant tear, is suspected.