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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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