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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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