Many of you have heard the word, but what is it really and how does it ruin so many weekends and workouts for people. So the name itself is inflammation of the tendon from a failed healing response. OK what’s a tendon. If you remember from grammar school it is the area that attaches the muscle to the bone. So common places for this are basically any part of your body that moves.
I volunteer at a runner’s clinic after the Boston Marathon where we see people a day or two after their race. I kept track of my day of seeing patients and their diagnoses. At the end of the day, I saw a patient with a tendonitis in every major tendon in the lower extremity-gluteus, quads, hamstrings, iliotibial band, peroneal, anterior tibial, posterior tibial, and of course the Achilles. So what does that tell us about tendonitis. It can strike any body part at any time, and there is a high chance of getting it, if you run 26 miles. Here’s the other demographic. The people we see are usually not the elite or professional runners. They are the people that decided to run and have fit it into their schedules of life and kids and work. So training plays a huge role in tendonitis. Is it too much training or too little?
From what I have seen tendonitis starts as a result of something different in life. New exercise, new weight, new distance, higher intensity, faster speed, change in course, change in repetitions. For the CrossFit world, you can see where things can go wrong fast. Take say Angie. 100 Pullups, 100 Pushups, 100 Situps, 100 Squats. Great workout, not for everyone. Tempting to jump in and have at it like anything in Crossfit…BUT…beware. My gym Crossfit New England does a good job at scaling recommendations for people as should other gyms. Here’s why
The tendon has to accommodate to stress. If the tendon is overstressed it will develop small microtears in its substance or collagen fibers. When enough of these microtears occur, inflammation kicks in. The body actually sends the same cells it uses to kill infections at your tendon (monocytes and macrophages) and they try to repair and remodel the tendon. These cells release substances that are noxious and painful, causing swelling and tenderness. Then the body sends the scar formers (fibroblasts) to try to strengthen the weakened area and decrease the inflammatory phase.You can see tendonitis on the left and normal tendon on the right. So what does this mean for you.
Say you have a biceps tendonitis or Achilles tendonitis. Bottom line when it comes to working out and avoiding injuries comes down to what I call it the rule of threes.. You should not have pain 1)while you are working out, 2) right after the workout, or 3) the next day. Call it what you will also…tightness, achiness, soreness, tweaked, spent. There is a difference between muscle fatigue and tendon pain that I hope everyone does not have a chance to feel, but when you get the latter you will know it.