Episode Transcript
Interviewer: Preventing tendon injuries, that's next on The Scope.
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Interviewer: You know, once you have them, tendon injuries can take a long time to improve so it's really better to prevent them from happening in the first place. Dr. Emily Harold is a sports medicine specialist at University of Utah Orthopedic Clinic. Now, there are a lot of different tendon-based injuries, but all of them can be avoided is your contention.
How Tendon Injuries Develop
Dr. Harold: Yes, tendon injuries are overuse injuries and whether you have it in your Achilles tendon or your patella tendon or tennis elbow, all of them are basically caused by the same kind of overuse. And all of them can be avoided if you practice some good tips to make sure you don't overstress your joints.
Interviewer: Okay. Ao when you say "overuse," is it just like when I go to the gym and work out and my muscles get sore, it's because I've used them a little harder than I should? Is it the same thing with the tendons or different?
Dr. Harold: Similar things. Our tendons are actually where the muscle connects to the tendon, and the tendon connects to the bone. And so they help your muscles work. And so when we say "overuse," if you're using the muscles in the same way on a repetitive basis that you have not yet had the correct training to do, that puts a lot more stress on the tendon and that can cause some inflammation and can lead to some tendonitis, where pain, as most people feel when they develop it.
Interviewer: So if I never played tennis before, never ran before, and all of a sudden I'm out there all the time doing that activity, it takes those tendons time to adapt is what I feel like you're saying.
Tendonitis
Dr. Harold: Yes, exactly. And anytime you've ever gone out in the spring and done a lot of yard work after you haven't done it in a while, that kind of thing, you can notice that you get more pain in joints. What happens with tendonitis is you keep overusing the tendon without enough time for the tendon to rest in between using it again. So it's not like you go out one day and then the next day you take off. It's you go out every day over and over again, and you're not used to that activity. And that puts a lot of stress to on the tendon that causes it to break down.
Interviewer: Okay. Is the breakdown in a similar way like muscles break down?
Dr. Harold: Similar. It's a breakdown that's more of a chronic inflammation of the tendon that doesn't allow the tendon to heal. So over time of repetitively doing it, if you were to look at the tendon under a microscope, you would see the tendon actually looks different than a healthy tendon. It has areas where there are different amounts of blood flow. It has some areas where the cells have changed and that causes a source of pain over time.
Advanced Stages of Tendonitis
Interviewer: When we start experiencing that pain, really, how advanced is your tendonitis by that point? I've been under the impression it's fairly advanced by then.
Dr. Harold: It's usually fairly advanced. Typically, it starts as a kind of pain that some people get off and on, and then usually what happens, it doesn't keep you from doing anything when it initially starts. So you feel the pain, but then you keep doing that same activity because you want to do it. And then it gets to the point where you can't do that activity anymore, and at that time it's very severe. It can be really hard to treat. Some of these tendon injuries can take three to six months of real good therapy and treatment to recover. And so it's much better to prevent them from happening in the first place.
Prevention Tips
Interviewer: All right. So what can be done so we don't develop tendon issues in the first place?
Listen to Your Body
Dr. Harold: Well, I think first, you need to pay attention to what your body is telling you. If you're someone who doesn't do a lot of running and then you want to train for a marathon, you need to start slow. You know, just go out and running 5, 6, 7 miles a day. When you do that, you put a lot of stress on the tendons that doesn't need to happen. So, one, pay attention to your fitness level, or your activity level, and make sure if you want to have a goal of reaching something, that you start slow and build up over time.
Interviewer: That's so hard to do, right?
Dr. Harold: Very hard to do.
Interviewer: Yeah, I've heard something like 5% in the case of running, for example.
Dr. Harold: Yeah, it is painfully slow. So if you out and run a mile, I saw people start every other day for about a week, and then you can increase by 5% either mileage or time. Meaning, if you run a 10-minute mile, next week you're running a 9.45 mile. But it's that that slow. It's so painful that almost no one does it, which is why we see a lot of tendon injuries.
Stretch After Exercising
Interviewer: Okay. So what are some other things I can do?
Dr. Harold: Other things you can do is make sure after you do exercise that you stretch afterward. A lot of people will warm-up stretch prior to exercise. It's actually much better to do it after when the muscle's warm. That's when you get the most benefit from stretching, and so that will help as well.
Interviewer: So what should I do to warm up, then, if I'm not stretching? Because I think a lot of people stretch to warm up, right?
Dr. Harold: Right. So typically, we say you want to start with about a five-minute warm-up that brings up the heart rate. So things like a light jog, brisk walking, riding a bike for five minutes, something to that extent.
Interviewer: But not stretching. Stretching after your activity.
Dr. Harold: Stretching after, not before.
Use Proper Exercise Techniques
Interviewer: Okay. And what are some other things? I hate tendonitis so I want to avoid it.
Dr. Harold: Another thing is to make sure that you're doing proper technique. So if you're going to go to the gym and you're going to lift weights, make sure that someone has shown you how to do techniques. You don't put undue stress on the muscles and the tendons. So don't just walk in off the couch and start doing the machines. Take one of those introductory classes. Or, I mean, now there's great stuff online. You can even get on YouTube and watch some technique. You just have to be careful it's coming from reputable sources.
Interviewer: It's using your body properly because otherwise, you're putting that undue stress on that tendon.
Dr. Harold: I think we've all had it where you sprain your ankle, and then you do out and you hurt the ankle on the other side or the knee on the other side just because your mechanics aren't the same. So it's important that people pay attention to appropriate mechanics when they do activity to keep them from overstressing an area.
Early Treatment is Key to Treating Tendon Injuries
Interviewer: So quickly, because this is about trying to prevent, but if you do have an issue, a tendon issue, I'd imagine the earlier you treat it, the better.
Dr. Harold: Yeah, absolutely. When you start to feel that pain in the tendon, make sure that you stop doing the activities that bother it. And then, initially, you can start with the ice and the anti-inflammatories. The earlier you catch it, the quicker it is to get better, but a lot of times, you will need some supervision with a therapist or other medical professional to try and fully resolve that issue before you go back to that activity.
Interviewer: So tendon issues aren't just a part of activity in life. You can actually make it that you are relatively pain-free if you do it smart.
Dr. Harold: Yes, you can make it so you don't have them very often.
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