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March 9, 2009

Tendonsis

I've discussed the differences between tendinitis and tendonosis before. Tendinitis is as it's name implies a condition where there is inflammation of a tendon, the connective tissue aspect of a muscle. Tendinitis is usually due to some sort of strain and it takes about two weeks for the inflammation to clear up. Over the counter anti-inflammatories are appropriate for this type of disorder.

Tendonosis is an overuse syndrome that many call tendinitis. It lacks an inflammatory component is is not really improved by the use of anti-inflammatories. A tendonosis condition takes around 8 months to heal, that is if the activity that caused it is terminated. Unfortunately, many over-use injuries are because of employment or posture. Learning how to use yourself differently takes time and practice. It is harder to unlearn an old, dysfunctional pattern and replace it with a new improved usage pattern than it is to learn a pattern correctly from the beginning.

I mention this topic because my husband, David, has a tenodesis injury at his elbow. His injury would be traditionally called tennis elbow if it was a pure inflammatory condition. What I have learned from school is that treatment of these two injuries falls under the scope of physical therapy, and that treatment for the condition is more comprehensive than my massage training prepared me for.

My treatment plan for David's tendinosis is as follows:
Examination: Discuss the history of the condition, its onset, duration, and intensity; check range of motion, strength, tissue extensibility. Try to ascertain what position elicits the greatest discomfort.
Evaluation: Involves taking all the facts and deciding what would be the best plan of care for the patient. At this point, a PT would decided whether the condition warrants a doctor's referral, a consultation with another health care professional (and this could be another PT with expertise in tenodesis), or to simply treat.
Diagnosis: This is not to be confused with a medical diagnosis -- MDs diagnose pathologies. A PT diagnosis encompasses impairments, functional limitations or disabilities associated with a pathology.
Prognosis: This is the optimal level of function within the context of the diagnosis -- it takes into consideration factors that may assist or limit return of function. For example, David's youth and good general health are factors that are in his favor. A factors that would negatively impact his recovery would be the fact that he uses the arm for his work every day.
Intervention: Includes what actions I would take with the patient in order to affect a change in the condition. In the case of tendonosis, considering the limitations in my education, I would choose cross-fiber friction massage, eccentric exercise for the forearm, stretching, and after all is done, alternate heat and ice as needed.

tags: massage massagetherapy wellness massage therapy bodywork health tendinosis

Posted by linda at March 9, 2009 7:16 PM