Tendonitis Symptoms and Our New Knowledge Base

Chiropractic was a bit ahead of its time

Back in the old days of med­i­cine (say 35 years ago when I was in chi­ro­prac­tic school) ten­don injuries seemed much sim­pler.

We had a basic mod­el of ten­don injuries:

  • If you over­loaded your mus­cle, the ten­don would part­ly tear.
  • It would swell up.
  • Then it would set­tle down and rebuild itself.  Maybe you’d take some anti-inflam­ma­to­ry drugs to resolve the swelling a lit­tle faster.

In real life, though, things were nev­er so sim­ple.  Plen­ty of peo­ple had nag­ging injuries that just nev­er seemed to go away.  And oth­er peo­ple had mus­cle and ten­don prob­lems that curi­ous­ly shift­ed from limb to limb.

Now we know much more about the com­plex nature of ten­don injuries and how to treat them.

Here are some hints that sci­en­tif­ic research is uncov­er­ing:

  • A patient with Achilles ten­donitis on both sides receives treat­ment on just one side, but both sides improve.
  • Some­one with “ten­nis elbow” (lat­er­al epi­condyli­tis) is helped by manip­u­la­tion of the joints of the neck.
  • Most prob­lem­at­ic ten­dons don’t show the clas­sic signs of inflam­ma­tion.

What links these facts togeth­er?  The brain and spinal cord invari­ably get into the act.

Any­time a ten­don is stressed out, your ner­vous sys­tem gets dis­tort­ed sen­so­ry sig­nals from it.  Then your brain’s com­pu­ta­tions are thrown off, and it shoots altered sig­nals back  to the ten­don.  It becomes a vicious cycle.

Your ten­don, like every oth­er liv­ing tis­sue, is try­ing to self-reg­u­late its health.  But if it’s get­ting the wrong brain sig­nals, the job becomes impos­si­ble.  The ten­don los­es struc­tur­al integri­ty.  It can no longer han­dle nor­mal mechan­i­cal forces.

The result?

  • Ten­nis elbow (lat­er­al epi­condyli­tis),
  • Knee cap pain (patel­lar or quadri­ceps ten­donitis),
  • Achilles ten­donitis
  • Any oth­er type of ten­don injury

Modern treatment of tendon injuries

Nowa­days, we know that prop­er treat­ment of ten­don injuries requires at least these three things:

  • Direct phys­i­cal treat­ment of the ten­don to stim­u­late heal­ing and change the sen­so­ry feed­back to the brain.
  • Mobi­liza­tion or manip­u­la­tion of the spinal region that’s the source of the nerve sup­ply of the ten­don.
  • Rehab exer­cise begin­ning with eccen­tric mus­cle load­ing to safe­ly rebuild mus­cle strength.

Chiropractic principles

The cen­tral role the ner­vous sys­tem plays in the health of body tis­sues is a con­cept fun­da­men­tal to the chi­ro­prac­tic approach to health.  It was orig­i­nal­ly for­mu­lat­ed due to the bril­liant intu­ition of D.D. Palmer, the “founder” of the chi­ro­prac­tic pro­fes­sion in 1895.  It’s been elab­o­rat­ed upon over the years as chi­ro­prac­tors’ expe­ri­ences inter­sect­ed with sci­en­tif­ic research.  Now it’s found even more sci­en­tif­ic sup­port as we deep­en our under­stand­ing of the under­ly­ing dynam­ics of ten­don injury.

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About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods.

His website, askdrlavine.com, provides more information about his approach.

Please contact him at drlavine@yourbodyofknowledge.com or at 212-400-9663.

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