Tendonitis: Why Won’t It Go Away?

Because it’s probably tendinosis.  Often, chronic tendonitis (also spelled tendinitis), which lasts more than 6 weeks is really tendinosis (also spelled tendonosis).  The difference is that acute, short-term tendinitis is thought to be caused by inflammation, which is an active immune response of the body to a perceived threat.  The acute, inflammatory tendonitis can be treated and usually resolved within several weeks by icing the area 3 to 4 times daily for 20-30 minutes, resting, and taking over-the-counter or prescription strength anti-inflammatory medication, such as ibuprofen.

Chronic tendonitis is usually defined by the tendon pain lasting more than 6 weeks, and the condition is more accurately referred to as tendinosis.  Tendinosis is mainly caused by degeneration of the tendon.  In order to effectively treat and resolve tendinosis, you must stimulate regeneration of the affected tendon.  There are very few approaches that do this.  Astym treatment has been used successfully for years and is the most established treatment to stimulate regeneration of a tendon and other soft tissues.  To view the resolution rates (outcomes) of Astym on particular types of tendonitis/tendinosis, click here:  http://www.astym.com/Content/documents/ASTYM%20Outcome%20Report.pdf

What is Astym treatment?: Astym Definition, Part III

Scientific studies have shown an increase in fibroblast recruitment and fibroblast activation with Astym treatment, which reveal the body’s underlying physiological response to Astym.  These studies highlight the regenerative mechanism of Astym treatment and help us understand how Astym treatment results in the regeneration of soft tissues. There also appears to be a neurological component to the Astym treatment process as evidenced by immediate changes in pain perception (often pain is immediately reduced) and strength measures (strength often immediately increases) following treatment.

At its core, Astym treatment was developed from basic science research to stimulate a regenerative response at a cellular level.  Following that, there were a number of case studies published and then a randomized clinical trial on patellar tendinopathy.  A large randomized clinical trial on lateral epicondylosis was then awarded a platform presentation at the American Society for Surgery of the Hand’s national meeting.

In addition to ongoing clinical and scientific research, the Astym program also emphasizes the collection of practical information.  Astym treatment has put major effort into developing a reliable national outcomes collection system and database, where clinicians from all across the country independently enter data to create a national bank of dependable outcomes data.  These outcomes (treatment results) show the percentage of people with each condition that resolve (get better).  Not only does this provide a good real-world evidence base for Astym treatment, it also allows patients and health care providers to know how many treatments it should take to resolve a certain condition, and what percentage of those cases should resolve.  For instance, for a patient with plantar fasciitis, you can predict that in 10 therapy visits, 91.8% of patients will be improved or much improved.  To see a full listing of diagnoses and outcomes, click here:  http://www.astym.com/Content/documents/ASTYM%20Outcome%20Report.pdf

What is Astym treatment?: Astym Definition, Part II

Astym treatment is effective in resolving many soft tissue problems, including chronic tendinopathies, tendon pain, tendon injury, stiffness, restricted movement, limited function and other conditions associated with adhesions or scar tissue that can occur after trauma or surgical intervention. It is also quite effective on sprains, strains, and other acute and sub-acute soft tissue injuries.  Continue reading What is Astym treatment?: Astym Definition, Part II

What is Astym treatment?: Astym Definition, Part I

Astym treatment is a regenerative therapy provided by specially trained (and certified) physical and occupational therapists.  Instruments are applied topically (on top of the skin) to locate dysfunctional (unhealthy) soft tissue, and to transfer pressure and shear forces to the underlying soft tissue structures.  The protocols, the force, and direction of the treatment induce a healing/regenerative response in tendons, muscles, and other soft tissue structures.  Astym treatment stimulates tissue turnover, scar tissue resorption, and the regeneration of tendons, muscles and other soft tissue structures. Therapy is typically provided twice weekly for three to four weeks and is done in conjunction with eccentric loading, stretching, and functional exercises. Continue reading What is Astym treatment?: Astym Definition, Part I

Heel Pain: Most Common Cause is Plantar Fasciitis

The tough band of tissue that connects your heel bone to your toes is called the plantar fascia.  It supports the arch of your foot, and when it becomes irritated or degenerated, then you have what is called plantar fasciitis (other names include: plantar fasciosis, which indicates degeneration, and plantar fasciopathy, which includes both degeneration and the inflammation indicated by plantar fasciitis).  This condition affects up to 2 million Americans each year.

Runners or people who are on their feet for long periods of time often get plantar fasciitis.  Also, people who are middle-aged, overweight or pregnant are susceptible to getting plantar fasciitis.  One of the most common symptoms of plantar fasciitis is foot pain in the morning getting out of bed or foot pain after getting up following prolonged sitting.  Once the foot loosens up it usually gets better unless you spend a lot of time on your feet or go running.

How can you get better?

Drugs to reduce inflammation are commonly prescribed and should help if the cause of the pain from plantar fasciitis is inflammation.  However, most long term plantar fasciitis is likely caused by degeneration of your plantar fascia, and in that case, medication to reduce inflammation will be ineffective to resolve the condition, although it may give some temporary pain relief. Rest, splints, stretches and modified shoes are also commonly recommended. Again, these treatments may also be effective if the condition is caused by inflammation, however, they will not be effective if the plantar fasciitis is caused by degeneration.

Plantar fasciitis caused by degeneration will often recur when resting is over, splints are removed, stretching is stopped or different shoes are worn.   Modifiying your lifestyle can help in certain cases, but the downside is that you have to keep it up.  To me, that is an indication that you haven’t cured the underlying problem, but rather you are constantly treating the symptoms and you are learning to live with the inconvenience.

Although it is not fully understood, researchers and a growing number of health care professionals recognize that almost all cases of chronic plantar fasciitis are due to degeneration of the plantar fascia, and treatment should involve stimulating regeneration of the affected tissue.  This link will show you some of the scientific evidence – histologic findings – that confirm this view: http://www.ncbi.nlm.nih.gov/pubmed/12756315.  Right now, there are very few approaches that focus on regenerating healthy tissue.  However, a good treatment option that focuses on stimulating regeneration and has a high rate of success for plantar fasciitis is Astym treatment.   You can see what Astym treatment is like by clicking here:  http://astym.com/video

Internal Scar Tissue/Adhesions Limit Movement and Cause Pain

Over time, internal scar tissue or adhesions can build up in your joints, muscles, tendons, and soft tissues.  It can be caused by working your body too much, injury (such as sprains, strains and trauma), surgery, disease, or just by moving and not being in absolute perfect physical condition or having perfect “form” when you move.  Stiffness and many of the aches and pains that we have after reaching a “certain age” are due to the build up of internal scar tissue and adhesions.  Astym treatment is effective at reducing or eliminating internal scar tissue or adhesions.

Once the scar tissue and adhesions are reduced or removed, stiffness, and aches and pains often go away.  Astym’s resolution rates (outcomes) for scar tissue and adhesions related pain are impressive.  Click on this link to see how many people resolve their conditions after Astym treatment: http://www.astym.com/Content/documents/ASTYM%20Outcome%20Report.pdf.  These outcomes were submitted by independent clinicians from all across the country.

About Thomas L. Sevier of Astym

Thomas L. Sevier, MD, FACSM is a double board certified physician, consultant, author and medical researcher. As a team physician and event physician, he has provided medical coverage for many high-profile sporting events. Dr. Sevier established the first ACGME accredited Sports Medicine Fellowship in the United States, and has served as a faculty member at two universities. He has helped pioneer important advances in rehab and sports medicine, and writes extensively for peer-reviewed journals, scientific publications and books. Dr. Sevier regularly speaks on medical and rehabilitation matters, and serves as an expert resource for medical and popular media outlets. Dr. Sevier is one of the few physicians who has been granted fellowship status in both the American College of Sports Medicine and in the American College of Physicians. 

Tendonitis vs. Tendinosis: Know what you have and how to treat it.

Tendons are the tough tissue that connects your muscles to your bones.  Often, tendons become painful and limit movement.  For years, almost all conditions of painful tendons were referred to as tendonitis.  Tendonitis (also spelled tendinitis) literally means that a tendon has inflammation, so doctors usually treated tendonitis by trying to reduce inflammation.  This kind of treatment had very little success.  Today, research has now shown us that chronic tendonitis only rarely has an element of inflammation.

Rather, the true problem is that the tendon has degenerated, and the condition should be more correctly called tendinosis (also spelled tendonosis).  To be effective, the treatment for tendinosis should center on regenerating the degenerated tissue, instead of trying to reduce inflammation which is not even present in most cases.

One of the best options for regenerating soft tissue is Astym treatment.  For years, the focus of its research and development has been on stimulating the regeneration of soft tissue.  You can find out more on this treatment at www.astym.com.

Restore – Revitalize – Recover