Common Gymnastics Injuries
Gymnastic injuries are common. They can be overuse injuries, overstrain or traumatic. Due to the age of most gymnasts, youth injuries that can affect your growth plates need to be thoroughly investigated to ensure minimal longstanding complications.
Gymnasts can suffer injuries to all body parts. A gymnast’s extremities are particularly at risk.
Wrist pain and strains are one of the most common gymnastics injuries. Not only are their wrists used for impact in tumbling and vaulting, but also with hanging apparatus such as bars and rings. This can also cause elbow injuries such as dislocation and shoulder pain is common with rotator cuff syndrome common.
Male gymnasts, in particular, suffer a condition known as pommel arm, which is aggravated by gripping activities such as rings and high bar and parallel bars. Pommel arm is technically medial epicondylitis, which is often referred to as golfers elbow.
Ankle injuries such as a sprained ankle are common from landings and tumbling on both firm and soft surfaces with twisting skills requiring instant stopping. Achilles tendonitis or Severs disease is likely due to the large landing and takeoff forces. Achilles tendon rupture is even more of an issue in the ageing gymnast due to the steady tendon cell degradation over time.
Likewise the knee is often under pressure with knee ligament injuries and ACL injury common. Gymnasts are also likely to suffer patella tendonitis or related conditions in the adolescent gymnast such as Osgood Schlatter’s or Sinding Larsen Johanssen Syndrome.
Gymnasts are also a very high risk of developing long-term lower back pain due to stress fracture in the lower vertebrae. This back stress fracture is known as spondylolysis and can develop in a lifetime condition known as spondylolisthesis. Bulging disc injures can also occur.
This may all sound like doom and gloom but it shouldn’t. Gymnasts develop wonderful flexibility, core control, all-body strength and incredible skills that few other sports can replicate.
For more information regarding the assessment and management of your gymnastics injury we highly recommend that seek the advice of a physiotherapist with a background or special interest in gymnastics.
Common Gymnastics Injuries
- AC Joint Injury
- Bursitis Shoulder
- Dislocated Shoulder
- Rotator Cuff Calcific Tendinitis
- Rotator Cuff Syndrome
- Rotator Cuff Tear
- Shoulder Impingement
- Shoulder Tendonitis
- Back Muscle Pain
- Bulging Disc
- Degenerative Disc Disease
- Facet Joint Pain
- Pinched Nerve
- Sacroiliac Joint Pain
Hip & Groin Injuries
- Adductor Tendinopathy
- Femoroacetabular Impingement (FAI)
- Gluteal Tendinopathy
- Greater Trochanteric Pain Syndrome
- Groin Strain
- Hip Arthritis (Osteoarthritis)
- Hip Labral Tear
- Osteitis Pubis
- Piriformis Syndrome
- Poor Hip Core
- Trochanteric Bursitis
- ACL Injury
- Bursitis Knee
- Chondromalacia Patella
- Fat Pad Syndrome
- ITB Syndrome
- Knee Arthritis
- Knee Ligament Injuries
- Lateral Collateral Ligament
- Medial Collateral Ligament Sprain
- Meniscus Tear
- Osgood Schlatter’s
- Patella Tendonitis (Tendinopathy)
- Patellofemoral Pain Syndrome
- Plica Syndrome
- Posterolateral Corner Injury
- Sinding Larsen Johansson Syndrome
Calf and Leg Injuries
- Achilles Tendon Rupture
- Achilles Tendonitis / Tendinitis
- Calf Muscle Tear
- Shin Splints
- Stress Fracture
Anke & Foot Injuries
- Anterior Ankle Impingement
- Heel Spur
- High Ankle Sprain
- Morton’s Neuroma
- Peroneal Tendonitis
- Pes Anserinus Bursitis & Tendinitis
- Pes Planus – Flat Feet
- Plantar Fasciitis
- Posterior Ankle Impingement
- Retrocalcaneal Bursitis
- Severs Disease
- Sprained Ankle
- Stress Fracture Feet
- Tibialis Posterior Tendinopathy
FAQs Gymnastics Injuries
Muscle Pain InjuriesMyalgia, or muscle pain, can have many sources. Here are some of the more common sources of your muscle pain. Please click the links for more information.
Muscle Strains By Region
Neck & Back:
Systemic Causes of Myalgia
More Information: Myalgia
Muscle Strain TreatmentMuscle strain treatment will vary depending upon an accurate diagnosis from your health professional. The severity of your muscle strain, and what function or loads your injured muscle will need to cope with, will impact the length of your healing and rehabilitation process. Until you’ve been accurately diagnosed with a muscle strain, use the following guidelines:
- Ice and a compression bandage.
- Elevate the injured region if it is swollen.
- If it’s painful to walk you should be using crutches.
- Cease or reduce your exercise or activity level to where you feel no pain.
Common Treatments for Muscle StrainThe following options are available to your physiotherapist to assist the rehabilitation of your muscle strain. Please seek their professional advice prior to self-managing your injury to avoid aggravating your muscle strain. These are general guidelines only and should not be treated as individual treatment advice.
Acute Muscle Strain Treatment
Subacute Muscle Strain Treatment
- Sub-Acute Soft Tissue Injury Treatment
- Acupuncture and Dry Needling
- Soft Tissue Massage
- Kinesiology Tape
- Supportive Taping & Strapping
- Electrotherapy & Local Modalities
- Heat Packs
Later Stage Muscle Strain Treatment Options
- Foam Roller
- Stretching Exercises
- Strength Exercises
- Closed Kinetic Chain Exercises
- Eccentric Exercises
- Proprioception & Balance Exercises
- Agility & Sport-Specific Exercises
Other Factors to Consider
- Biomechanical Analysis
- Joint Mobilisation Techniques
- Gait Analysis
- Running Analysis
- Video Analysis
- Active Release Technique - ART
- Deep Tissue Massage
- Lymphatic Drainage
- Myofascial Release
- Pregnancy Massage
- Relaxation Massage
- Remedial Massage
- Sports Massage
- Sports Recovery Massage
- Swedish Massage
- Therapeutic Massage
- Trigger Point Therapy
Sports Injury Management
You probably already know that a sports injury can affect not only your performance but also your lifestyle. The latest research continues to change sports injury management considerably. Our challenge is to keep up to date with the latest research and put them to work for you.
How we treated you last year could vary significantly to how we treat you this year. The good news is that you can benefit considerably from our knowledge.
What Should You Do When You Suffer a Sports Injury?
Rest from painful exercise or a movement is essential in the early injury stage. "No pain. No gain." does not apply in most cases. The rule of thumb is - don't do anything that reproduces your pain for the initial two or three days. After that, you need to get it moving, or other problems will develop.
Ice or Heat?
We usually recommend avoiding heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. In traumatic injuries, such as ligament sprains, muscle tears or bruising, ice should help reduce your pain and swelling.
Once the "heat" has come out of your injury, you can use heat packs. We recommend 20-minute applications a few times a day to increase the blood flow and hasten your healing rate. The heat will also help your muscles relax and ease your pain. If you're not sure what to do, please call us to discuss your situation specifically.
Should You Use a Compressive Bandage?
Yes. A compressive bandage will help to control swelling and bleeding in the first few days. In most cases, the compressive dressing will also help support the injury as you lay down the new scar tissue. This early healing should help to reduce your pain. Some injuries will benefit from more rigid support such as a brace or strapping tape. Please ask us if you are uncertain about what to do next.
Gravity will encourage swelling to settle at the lowest point. Elevation of an injury in the first few days is beneficial, especially for ankle or hand injuries. Think where your damage is and where your heart is. Try to rest your injury above your heart.
What Medication Should You Use?
Your Doctor or Pharmacist may recommend pain killers or an anti-inflammatory drug. It is best to seek their professional advice as certain medications can interfere with other health conditions, especially asthmatics.
When Should You Commence Physio?
In most cases, "the early bird gets the worm". Researchers have found that the intervention of physiotherapy treatment within a few days has many benefits. These include:
- Relieving your pain quicker via joint mobility techniques, massage and electrotherapy
- Improving your scar tissue using techniques to guide the direction it forms
- Getting you back to sport or work quicker through faster healing rates
- Loosening or strengthening of your injured region with individually prescribed exercises
- Improving your performance when you return to sport - we'll detect and help you correct any biomechanical faults that may affect your technique or predispose you to injury.
What If You Do Nothing?
Research tells us that injuries left untreated take longer to heal and have lingering pain. They are also more likely to recur and leave you with either joint stiffness or muscle weakness. It's important to remember that symptoms lasting longer than three months become habitual and are much harder to solve. The sooner you get on top of your symptoms, the better your outcome.
What About Arthritis?
Previously injured joints can prematurely become arthritic through neglect. Generally, there are four main reasons why you develop arthritis:
- An inappropriately treated previous injury (e.g. old joint or ligament sprains)
- Poor joint positioning (biomechanical faults)
- Stiff joints (lack of movement diminishes joint nutrition)
- Loose joints (excessive sloppiness causes joint damage through poor control)
What About Your Return to Sport?
Your physiotherapist will guide you safely back to the level of sport at which you wish to participate. If you need guidance, ask us.
What If You Need Surgery or X-rays?
Not only will your physio diagnose your sports injury and give you the "peace of mind" associated, but they'll also refer you elsewhere if that's what's best for you. Think about it. You could be suffering needlessly from a sports injury. Please use our advice to guide you out of pain quicker. And for a lot longer.
If you have any questions regarding your sports injury (or any other condition), please contact your physiotherapist to discuss. You'll find our friendly staff happy to point you in the right direction.
Acute Sports Injury Clinic
How to Best Care for Your Sports Injury?
There is never an excellent time for an injury. But we do know that most sports injuries occur over the weekend! That's why at PhysioWorks, we have established an Acute Sports Injury Clinic at a selection of our clinics on a Monday and Tuesday.
The acute sports injury consultation fee is significantly lower than a routine assessment and treatment consultation. In most cases, your private health will cover the full cost of your full acute injury physio assessment fee.
Why Use an Acute Sports Injury Clinic?
Your Acute Sports Injury Assessment Consultation allows us to provide you with:
- A quick and accurate diagnosis. One of our Sports Physiotherapist's or an experienced sports injury-focused Physiotherapist will confidently guide your new injury management.
- Early acute sports injury care, professional advice and education. What to do this week?
- Fast referral for X-rays, ultrasound or MRI scans to confirm your diagnosis.
- Prompt referral to Sports Physicians, GPs or Surgeons with whom we work if required.
- Immediate supply of walking boots, braces and rental crutches if needed.
- Low-cost professional service.
For more friendly advice or guidance, please call your nearest clinic to discuss your specific needs.
Who is a Sports Physiotherapist?
Sports Physiotherapy is the specialised branch of physiotherapy which deals with injuries and issues related to spokespeople. Practitioners with additional formal training within Australia are Sports & Exercise Physiotherapists.
What is Sports Physiotherapy?
Sports injuries do differ from common everyday injuries. Athletes usually require high-level performance and demand placed upon their body, which stresses their muscles, joints and bones to the limit. Sports physiotherapists help athletes recover from sporting injuries, and provide education and resources to prevent problems.
Each sports physiotherapist usually has sport-specific knowledge that addresses acute, chronic and overuse injuries. Their services are generally available to sportsmen and women of all ages engaged in sports at any level of competition.
Members of Sports Physiotherapy Australia (SPA) have experience and knowledge of the latest evidence-based practice, skilled assessment and diagnosis of sports injuries, and use effective 'hands-on' management techniques and exercise protocols to assist recovery and prevent future damage. SPA members have access to the most recent advances in sports physiotherapy. You'll be pleased to know that most of PhysioWorks physiotherapists and massage therapists have a particular interest in sports injury management.
What is Physiotherapy Treatment?
Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques education and advice. Physiotherapists maintain physical health, help patients to manage pain and prevent disease for people of all ages. Physiotherapists help to encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing activities of daily living while assisting them to remain functionally independent.
There is a multitude of different physiotherapy treatment approaches.
Acute & Sub-Acute Injury Management
Hands-On Physiotherapy Techniques
Your physiotherapist's training includes hands-on physiotherapy techniques such as:
- Joint Mobilisation (gentle joint gliding techniques)
- Joint Manipulation
- Physiotherapy Instrument Mobilisation (PIM)
- Minimal Energy Techniques (METs)
- Soft Tissue Techniques
Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, just to name a few.
Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.
Alternatively, your physiotherapist may recommend a supportive brace.
Acupuncture and Dry Needling
Many physiotherapists have acquired additional training in the field of acupuncture and dry needling to assist pain relief and muscle function.
Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly-skilled in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.
- Muscle Stretching
- Core Exercises
- Strengthening Exercises
- Balance Exercises
- Proprioception Exercises
- Real-Time Ultrasound Physiotherapy
- Swiss Ball Exercises
Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.
Aquatic water exercises are an effective method to provide low bodyweight exercises.
Sports physio requires an extra level of knowledge and physiotherapy skill to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports Physiotherapist.
Women's Health Physiotherapy is a particular interest group of therapies.
Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstation set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.
Plus Much More
Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your individual problem, please contact your PhysioWorks team.
Post Running Muscle Soreness:
Is it an Injury or just DOMS?Have you ever finished a big run and felt sore right after it? What about two days afterwards? Do you ignore it or have it checked out? The most common causes of post-run pain are either a legitimate muscle injury or delayed onset muscle soreness (DOMS).
Tips to Determine if it is a Muscle Injury or is it DOMS?Differentiating between a muscular injury and DOMs is essential to ensure you are not overlooking a potentially sport-limiting injury and you are getting the injury managed appropriately. Early identification is key!
What is DOMS?Delayed Onset Muscle Soreness or DOMs for short, is an exercise-related muscle condition that arises after intense, unaccustomed, physical exercise. The condition gets its ‘delayed’ name as symptoms are not usually felt until 24 to 72 hours after the exercise, normally peaking at the 48-hour mark after exercise. Research has demonstrated that DOMS is associated with tearing of myofibrils often at multitudinous junctions - best described as microtrauma. This process is followed by inflammation and a shift in intramuscular fluid and electrolytes. This process in combination with other local factors at the cellular and increased intramuscular pressure promote are what causes the soreness and stiffness experienced in DOMS. Tenderness is typically felt at the end of the muscle (at the tendon) where it attaches down along the affected limb and then as the condition progress. This can be felt throughout the muscle belly itself. The swelling, inflammation, tenderness and pain that arises can manifest as decreased joint range of motion, decreased strength and a decreased ability to absorb shock while exercising. This alteration is muscle function can last up to 10 days!
Muscle InjuriesAcute muscle injuries are quite different in how they present compared to DOMS. Typically, pain and stiffness is felt immediately in the affected tissue or shortly after. A ‘pop’, twinge, feeling of being kicked - without anyone actually kicking you - or an immediate collapse to the ground. As expected, the amount of damage to the tissue with a muscle injury exceeds that of DOMS. Any general movement of the muscle will reproduce your symptoms and if the injury is severe enough - bruising can begin to develop with some associated swelling. At the time of injury, following the RICE protocol (Relative Rest, Ice, Compression, and Elevation) is your best go-to treatment. You should also avoid HARM factors. No heat should be applied to the affected area. You should also avoid alcohol consumption, running or other painful movements. Initially, it is a good idea to avoid massage until a professional has assessed the injury. All the HARM factors have the potential to increase bleeding, which may exacerbate your injury. Research suggests no anti-inflammatory drugs following a muscle strain is the best way to go. If you are seeking pain relief, it is best you consult your regular GP or a pharmacist for pain relief options that don't slow down your healing rates. More info: How to Treat an Acute Soft Tissue Injury
Benefits of DOMS?Thankfully yes! The body adapts to the physical exercise that was undertaken once the DOMS resolves. So when you go and perform the same exercise again, the chance of DOMS onset decreases! However, adaptation to the causative exercise occurs rapidly after DOMS resolves. This adaptation with repeated exercise is called the “repeated-bout effect.” More info: Delayed Onset Muscle Soreness (DOMS).
How to Tell the Difference?Your physiotherapist will be your best option for an efficient and accurate diagnosis between the two conditions, however, there are some simple factors to help piece together your injury when it comes to deciding whether or not to consult help. DOMS is more unpleasant when commencing a movement but eases as the muscle is warmed up, whereas a muscle injury will reproduce pain with any movement of the injured muscle. The most definitive factor is taking a detailed history of the injury. If pain was experienced during the event or immediately after, you are most likely looking at a muscle injury. If the pain is worst the day after and gets worse over the following days, you are most likely dealing with DOMS.
What to Do if You Have DOMS or a Muscle Injury?If you suspect you have a muscle injury, it is best to consult your physiotherapist earlier rather than later. A thorough assessment is required to ascertain what exactly it is you have injured and start rehabilitation immediately to help minimise your time out of the sport! If you suspect you have DOMS, you need to avoid therapeutic interventions that increase muscle pain (e.g. excessive stretching, deep tissue massage) and vigorous physical activity should be postponed until resolution of pain and restoration of function due to:
- Decreased shock absorption
- Decreased coordination of muscle sequencing motion
- Compensatory recruitment of uninjured muscle groups
- Increased relative work intensity of the affected muscles at the same workload
- Altered strength balance of agonist and antagonist groups
- Inaccurate perception of functional deficits
What Massage Style is Best for You?
Yes. Massage styles and techniques can be confusing, which is why your PhysioWorks Massage Therapist is a highly-trained professional who understands was is right for your body. If you have any questions about what massage techniques are the best for you, please call us to discuss your massage requirements. Or, let your massage therapist works their wonders on your body during a consultation.
What are the Basic Massage Techniques?
Longitudinal gliding is a traditional effective massage technique administered in the direction of the blood flow. It aids the fluid dispersion from the injury site and thus helps reduce inflammation and swelling. It is also instrumental in relaxing tight muscles.
Kneading can be performed in different ways and described by the hand method used to accomplish the massage, e.g. thumb kneading and palm kneading. The massage pressure applied must vary according to the purpose of the massage. The rhythm and rate of the movement are equally important as the load is applied intermittently.
Myofascial release is a manual technique for stretching the fascia to balance the body. Your fascia, located between the skin and the underlying muscle and bone structure, is a seamless web of connective tissue that covers and connects the muscles, organs, and skeletal systems in our body. Injuries, stress, trauma, and poor posture can cause restriction to the fascia, and the goal of myofascial release is to release fascia restriction and restore its tissue.
Trigger point therapy is a bodywork technique that involves applying pressure to tender muscle tissue to relieve pain and dysfunction in other parts of the body. Trigger points are active centres of muscular hyperactivity, which often cross-over with acupuncture points. You will also find that common trigger points are what the average person refers to as muscular "knots".
Transverse friction is transverse connective tissue therapy applied directly by the fingers. Transverse frictions use an oscillating pressure applied across the direction of the tissue fibres. This technique is used mainly on tendon or ligament injuries to help break down thickened, pain-producing scar tissue. Unreduced lesions are likely to cause further irritation and degenerate more quickly than they should.
Rhythmic compression into muscles is used to create deep hyperaemia and softening effect in the tissues. This technique may occur as a warm-up for more in-depth, more specific massage work. Sports massage utilises compression massage.
Cross-fibre friction techniques create a stretching and broadening effect. It can also help reduce adhesions and help build reliable, flexible repair during the healing process.
PNF Stretches (Proprioceptive Neuromuscular Facilitation) combine passive stretching, and isometrics with your muscle alternatingly stretched passively and contracted. The method targets nerve receptors in muscles to extend the muscle length.
For specific information regarding the best massage technique for you, please consult your trusted massage therapist.
What is the Difference Between Remedial and Relaxation Massage?Have you ever wanted a massage but couldn’t decide whether you need a remedial massage or only a refreshing and stress-reducing relaxation session? Well here’s an explanation to help you to determine what you want precisely!
What is Relaxation Massage?A relaxation massage helps to de-stress and loosen up your body and is excellent for those who have had a hard working week or feel like treating themselves to some TLC! The treatment consists of flowing strokes, kneading and gentle manipulations of the muscles performed at your chosen pressure. It is a pain-free way to relax both your muscles and your mind.
What is a Remedial Massage?If you have particular muscle tension or chronic pain, a remedial massage may be for you. Your remedial massage therapist will assess where you need treatment and what may be causing your pain. They’ll perform some tests to identify which muscles give you trouble and tailor a treatment plan to suit. The treatment itself may involve deep tissue work for short periods, but the results are worth it! Remedial massage may quickly ease conditions such as sciatica, carpal tunnel, stiff necks, headaches, sports injuries and many more complaints can be relieved with a remedial treatment. If you’d like more advice regarding what’s best for you, please call us to discuss your condition. Or book your appointment and enjoy the benefits. Private health fund rebates are also available.
What is a Pre-Event Massage?Pre-event massage occurs before a workout, competition or sporting performance. Pre-event massage aims to increase blood circulation, flexibility and mentally prepare people for activity and enhance performance. Pre-event massage is short and specific massage treatment. Before an event, 3-5 days before, a deep tissue massage can be incredibly beneficial. You can release knots, relax tired muscles, improve your range of motion and get a much-needed break from your training schedule. If you're considering a pre-event massage or post-event recovery massage, your timing is essential for maximum benefit.
When is the Best Time for a Pre-Event Sports Massage?Pre-event massages that require deep tissue techniques should occur no later than 48 to 72 hours before the planned exercise event.
Is it Bad to Get a Massage the Day Before a Game or Event?Any massage undertaken in the 48-hours prior should be light relaxation only. If you have a sporting event coming up soon, please discuss your timeframes with your sports massage therapist to ensure that your muscles work optimally on the big day. More info:
Post-Event Recovery MassageA post-event massage occurs soon after intense training or competition as part of the recovery process. Post-event massage involves the application of a range of massage techniques to assist recovery from activity. Post-event recovery massages are most effective within a few days of your sporting event. It is always a good idea to present yourself at the post-event massage tent if one is available for your light rubdown. Post-event massage can be performed from 30 minutes up to 48 hours after intense exercise.
How Long Does a Post-Event Massage Last?
What is Normal Post-Exercise Soreness?Normal post-exercise soreness should settle within a day or two. Pain or soreness lasting beyond 48 hours is likely to be injury-related. If this is your case, we recommend seeking professional assessment and management of any suspected injuries. More info: Sports Recovery Massage Sports Massage DOMS - Delayed Onset Muscle Soreness Muscle Injuries
- tendon insertion (where the tendon attaches to the bone)
- mid-tendon (non-insertional tendinopathy)
- musculotendinous junction (where the tendon attaches to the muscle)
What is a Tendon Injury?Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to occur suddenly, but usually, it is the result of repetitive tendon overloading. As mentioned earlier, health care professionals may use different terms to describe a tendon injury. You may hear: Tendinitis (or Tendonitis): This means "inflammation of the tendon". Mild inflammation is actually a normal tendon healing response to exercise or activity loading, but it can become excessive, where the rate of injury exceeds your healing capacity.
Tendinopathy PhasesThe inability of your tendon to adapt to the load quickly enough causes the tendon to progress through four phases of tendon injury. While it is healthy for normal tissue adaptation during phase one, further progression can lead to tendon cell death and subsequent tendon rupture.
1. Reactive Tendinopathy
- Normal tissue adaptation phase
- Prognosis: Excellent.
- Normal Recovery!
2. Tendon Dysrepair
- Injury rate > Repair rate
- Prognosis: Good.
- The tendon tissue is attempting to heal.
- It is vital that you prevent deterioration and progression to permanent cell death (phase 3).
3. Degenerative Tendinopathy
- Cell death occurs
- Prognosis: Poor!
- Tendon cells are dying!
4. Tendon Tear or Rupture
- Catastrophic tissue breakdown
- Loss of function.
- Prognosis: very poor.
- Surgery is often the only option.
What is Your Tendinopathy Phase?It is very important to have your tendinopathy professionally assessed to identify it’s current injury phase. Identifying your tendinopathy phase is also vital to direct your most effective treatment since certain treatment modalities or exercises should only be applied or undertaken in specific tendon healing phases.
Systemic Risk FactorsThe evidence is growing that it is more than just the tendon and overload that causes tendinopathy. Diabetics, post-menopausal women and men with high central adiposity (body fat) seem to be predisposed to tendinopathies and will need to carefully watch their training loads.
What are the Symptoms of Tendinopathy?Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.
- The pain may get worse when you use the tendon.
- You may have more pain and stiffness during the night or when you get up in the morning.
- The area may be tender, red, warm, or swollen if there is inflammation.
- You may notice a crunchy sound or feeling when you use the tendon.
How is a Tendon Injury Diagnosed?To diagnose a tendon injury, your physiotherapist or doctor will ask questions about your past health, your symptoms and recent exercise regime. They'll undertake a thorough physical examination to confirm the diagnosis. They will then discuss your condition and devise an individualised treatment plan. They may refer you for specific diagnostic tests, such as an ultrasound scan or MRI.
Tendinopathy TreatmentTendinopathies can normally be quickly and effectively rehabilitated. However, there is a percentage of tendinopathies that can take months to treat effectively. As mentioned earlier in this article, it is important to know what phase your tendinopathy currently is. You physiotherapist can assist not only your diagnosis but also guide your treatment to fast-track your recovery. Before you seek the advice of your physiotherapist or doctor, you can start treating an acute tendon injury at home. To achieve the best results, start these steps right away:
- Rest the painful area, and avoid any activity that makes the pain worse.
- Apply ice or cold packs for 20 minutes at a time, as often as 2 times an hour, for the first 72 hours. Keep using ice as long as it helps.
- Do gentle range-of-motion exercises and stretching to prevent stiffness.
When to Return to SportEvery tendinopathy is different, so please be guided by your physiotherapist assessment. It may take weeks or months for some tendon injury to heal and safely cope with a return to sporting loads. Be patient, and stick with the treatment exercises and load doses prescribed by your physiotherapist. If you start using the injured tendon too soon, it can lead to more damage, and set you back weeks!
Tendinopathy PreventionTo minimise reinjuring your tendon, you may require some long-term changes to your exercise activities. These should be discussed with your physiotherapist. Some factors that could influence your tendinopathy risk include:
- Altering your sport/activities or your technique
- Regular prevention exercises.
- Closely monitoring and record your exercise loads. Discuss your loading with your physiotherapist and coach. They will have some excellent tips.
- Always take time to warm up before and cool down / stretch after you exercise.