Feb 12, 2019

Interviewer: Yous institute out yous accept tendonitis. Probably wondering what treatments are available, what do you demand to know about them and what to await after. We're going to talk about that next, on The Scope.

Journalist: Health data from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.

Interviewer: Dr. David Petron is an orthopedic sports medicine specialist at Academy of Utah Health Care and is also the chief medical officer for the Utah Jazz basketball team. So he knows what he's doing and today we're going to talk about tendonitis.

What Is Tendonitis?

Dr. Petron: Well showtime let me say what tendonitis is. There can be confusion almost it. Tendon is muscle connected to bone. So at the cease of the muscle, that'southward where the tendon is and so the tendon ultimately attaches to the os. -Itis infers that information technology's an inflammation problem, when in fact near tendonitis is actually what we call tendonosis because it ends up being a chronic problem. Normally in the kickoff few weeks or perhaps the showtime calendar month we might call it tendonitis. After that it really is non an inflammatory problem, simply it's more of a tissue pause downwards trouble and then we call information technology tendonosis.

Interviewer: And that'southward something that's not going to get abroad without some sort of intervention. Is that right?

Dr. Petron: Frequently that'due south the case and mostly the older the patient is, the longer it can accept to go away. Only even sometimes with prolonged rest, as before long as somebody goes back to doing their usual activity, the tendonosis problem comes back again.

Handling Options for Tendonitis

Interviewer: So something's going to have to happen, what are the options? Typically are there a lot?

Dr. Petron: At that place a lot of options. The i thing that all these options have in common is they do something to disturb the tissue. So it gets in a chronic pattern where it won't heal itself and we demand to practice something to disturb that tendon to try to get the trunk to feel like it's an acute injury so that it can ultimately heal itself.

  • Rest and ice

    Early on the treatments are bourgeois, later on they tin can become more than interventional. Some of the early on treatments of class are just rest and water ice, and relative rest. So say information technology's a swimming problem and a shoulder trouble, you might be able to stay in aerobic shape past running or riding a bike, working on some shoulder exercises while y'all ease your fashion back into the pool. And then that tin can be some of the most uncomplicated treatment, only relative rest and then gradual return to action.

  • Anti-inflammatories

    Oft people take anti-inflammatories and they're helpful for the pain, but they're not really helpful for healing. In fact there are some studies that show that they may really boring downward healing. Cortisone is something that people oftentimes may encounter at their doc's office. And I remember that'south okay when you're in the -itis stage, so the inflammatory phase. Only later on nosotros actually know that cortisone can wearisome downwardly healing and cortisone in a tendon tin actually weaken the tendon, so we've got to be careful nearly that.

Some of the more than avant-garde treatments I'll just talk almost briefly.

  • Focused aspiration of scar tissue (FAST)

    There's something called FAST or focused aspiration of scar tissue. This is a newer treatment where you lot use a percutaneous needle that vibrates nearly 2000 times a 2nd and then it has irrigation that goes in and fluid that sucks out the necrotic tissue. So it'southward a way of removing the scar tissue merely kind of through a poke hole through the skin's surface.

  • Platelet rich plasma (PRP)

    Some of y'all may have heard of PRP or platelet rich plasma. That's where nosotros describe your own blood off, spin it down, remove the platelets, which have some healing properties, and then re-inject that back into the tendon. Once again to disturb the tissue and attempt to requite it a bound commencement to ultimately heal itself. Fifty-fifty some apply of stem cells now using in a similar manner as PRP.

  • Astym

    Sometimes physical therapists volition do something chosen Astym where they're using—I call information technology a butter pocketknife—but it's basically some tools that they're rubbing, kind of like a deep tissue massage. Again to try to disturb that tendon to try to get it to turn over and heal itself.

  • Extracorporeal shock moving ridge therapy

    • And then one other thing that we exercise is called extracorporeal shock moving ridge therapy, which is kind of like a de-tuned lithotripsy. Same kind of technology used to break up a kidney rock. But y'all do that on the skin surface, again to disturb the tissue, break upward the degenerative tissue forth the tendon to become that to heal. And so there are a few of the more advanced treatments that are being used now for tendons to heal.

Choosing a Handling Option

Interviewer: My head's spinning. There's so many of them.

Dr. Petron: In that location's a lot out at that place, and like most things when in that location's a lot of dissimilar ways to arroyo information technology, not one style is perfect. So the doctor needs to evaluate the patient and see what might be best for their state of affairs.

Interviewer: Yeah that really sounds like you practise need an practiced. I mean you can do a little reading on the internet, just it sounds like an expert really needs to decide what is going to be best for your state of affairs.

Dr. Petron: Correct, in the early phases though relative residue and gradual return to activity in a lot of patients practise well. But once you've had this for three months or six months or longer, probably ought to see a doc.

Interviewer: And then getting in early is ever the amend choice.

Dr. Petron: Right, if you beginning to experience some breakdown say in an Achilles tendon or a rotator gage in your shoulder, stop. Because once y'all go into that tendonosis stage, it can be very difficult to become ameliorate.

How Long Until Treatments Piece of work?

Interviewer: What are some mutual questions people have nearly these treatments?

Dr. Petron: 1 of the mutual things is when one of these treatments is done, is it going to instantly be amend? And the reply to that is no. So some of that might exist lowering the expectation. Because again, actually the body withal has to heal itself. So even with these treatments, it can ordinarily be three months or so until they're healed.

Interviewer: So in three months, back to 100%? I hateful is that fair?

Dr. Petron: Usually at least back to activity, their usual activity.

Interviewer: And then how do you preclude—

Dr. Petron: But at that place are some areas that really have a lousy blood supply, like the Achilles tendon. In one case that's actually inflamed, that tin be fifty-fifty longer than that to return to play.

Preventing New Injuries After Handling

Interviewer: And so I get the handling, I'm back to activity. How do I prevent this from now happening once more and being a vicious circle?

Dr. Petron: Well the almost important thing is starting time out slowly. All of these problems are non traumatic injuries, they're overuse injuries. So it's doing as well much likewise chop-chop. So in general, the older the athlete, the slower y'all ought to ease into your particular sport.

Interviewer: And then eventually your body is going to exist able to handle anything y'all throw at information technology?

Dr. Petron: The body adapts to the stresses put upon it. And so just like a weight lifter gradually lifting more and more weight, muscles get bigger, tendons go stronger. That tin can happen to every part of your body. Basic get stronger, tendons get stronger, ligaments go stronger as you put stress on information technology. But the cardinal is you need to practise that in a controlled fashion.

Interviewer: Let's wrap this up with the concluding thought. What do yous recollect the big takeaway is?

Dr. Petron: Prevention is always central, and then if y'all start to go feeling of tendon pain then back off on that activity. Relative rest, which means you can notwithstanding stay active but don't overuse that tendon. If you practise overuse it and you have the symptoms for say three months or longer, probably should seek the intendance of a physician.

Announcer: Take a question nigh a medical procedure? Want to learn more about a wellness condition? With over ii,000 interviews with our physicians and specialists, there's a pretty good gamble you'll notice what you want to know. Bank check it out at TheScopeRadio.com.


updated: Feb 12, 2019
originally published: April 8, 2015

Heart Health

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