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Tendinitis: how to treat and prevent them

by Cédric Jourdan © Copyright
Athlete suffering from tendinitis

An inflammation of the tendon which takes a long time to heal but which can be prevented by taking a few precautions

Tendinitis is the sportsman's obsession. They settle insidiously in a few days, causing pain and stagnation, then take several weeks to disappear. It's best to avoid them! Let's see together how to prevent tendinitis and treat it effectively so that it no longer compromises your sporting performance.

What are tendinitises due to?

Sometimes fate takes its toll and you become, in spite of yourself, an expert in a particular field. This is exactly what I experienced with my tendinitis. Knees, wrists, elbows, heels, in short, everything has been there in the course of my sports activities (basketball, floor gymnastics, weight training and triathlon). 150 sessions of physiotherapy and a surgical operation later, I think I have mastered the subject and will bring you all my knowledge to anticipate them as soon as possible.

Tendinitis, which is well established, is undoubtedly one of the most time-consuming injuries to treat. Belonging to the family of musculoskeletal disorders, tendinitis is the result of an inflammation of a tendon. The term tendinopathy is broader since it includes all tendon pains such as chronic non-inflammatory degeneration or a lesion of the synovial sheath inducing tendon compression. In short, in any case, you are alerted by an unpleasant pain which should not be ignored.

"Understanding tendinitis" means that by continuing your sports activity despite the pain, the problem only tends to get worse. We strongly advise you to stop the movement causing the discomfort in order to treat your tendonitis from the 1st day.

The 3 stages of severity of a tendinitis

Stage I: The pain disappears with effort.
Stage II: Initially calmed by movement, the tendinitis reappears during activity in an increasingly early and intense way.Stage III: Permanent pain, more or less well calmed by rest, and prevents any activity.

How to prevent tendinitis?

The importance of good training

Some tendinitis is specific to a particular sport. One thinks of tennis elbow and golf elbow (elbow pain). It can be a bad technique, a bad gesture, but also overtraining with a movement repeated over and over again. Nevertheless, everyone can be prone to tendinitis, even in the office, hence the interest in developing the ergonomics of the workplace.

Women doing stretching
A good warm-up and, depending on the sport, some stretching, are important to avoid tendinitis

"Training well or training smart" means that your session must be personalised. Each individual has their own morphology, their own flexibility, different limb lengths and muscles that are either long or short depending on your insertions. So, for example, in weight training, the bench press exercise is not suitable for everyone. For Arthur, it will give him excellent results on his pectorals, while Tom will suffer greatly from his shoulders and will prefer a version with dumbbells, which is less stressful for his tendons. In fact, don't hesitate to get help from a competent sports coach to select the exercises best suited to your morphology.

The warm-up as well as relaxation exercises are of paramount importance to avoid the appearance of tendon inflammations. Don't neglect these phases during your training sessions.

Favour alkalinising foods and good hydration

Diet has a role to play on tendinitis. A diet which is too "acidic" is conducive to tendinitis. Conversely, eating alkaline foods can prevent it to a certain extent. So, do not hesitate to document yourself on acid-base balance.

Foods to be preferred (alkalizing)Foods to be moderated (acidifiers)
Fruits (banana, grape, kiwi, apricot)Meat
Vegetables (spinach, zucchini, radish)Fish
Lemon & mineral waterŒufs
Spices and herbsCocoa
AlmondsDairy products
Seeds (pumpkin, poppy, flax)Alcohol
Foods to be preferred and moderated to prevent tendinitis

As a sportsman, we sometimes opt for a high-protein diet. In this case, we should redouble our efforts on fruit and vegetables in order to regain a suitable acid-base balance. If you wish, there are pH strips available in pharmacies that allow you to easily determine your acidity level in order to remedy this.

Recovery to avoid injury

Tendonitis can be the source of overwork. A lack of muscle or joint recovery greatly increases the risk of tendinopathies. Don't wait for pain to appear before resting. 24 to 48 hours are necessary for your body to recover between two training sessions, as long as your sleep and your diet are of good quality. Proteins and carbohydrates also have an important role to play.

If you watch the top athletes on television, like in the NBA, you can see that they place ice packs on their knees or neck at every time they are not training. So don't hesitate to use different techniques to recover well, all year round (physiotherapy, self-massage, cryotherapy, stretching).

How to treat tendinitis?

Avoid anti-inflammatory drugs (NSAIDs)

The use of anti-inflammatory drugs should remain exceptional. In most cases, it is advisable to apply cold twice a day for 20 minutes and to position the limb in partial rest. This means that a total cessation of sport is not useful or advisable for the healing of the tendon. However, it is advisable to avoid waking up the pain. Therefore be attentive to painful movements in order to limit them as much as possible.

A medical opinion is strongly recommended to make a concrete diagnosis of your injury. For tendonitis, an ultrasound or MRI should be considered according to your sports doctor.

The Stanish protocol

Your doctor will refer you to a physiotherapist in order to take care of your pathology quickly. The programme includes deep transverse massage (TPM) or shock waves, stretching, icing, as well as the famous Stanish protocol. This protocol applicable to tendinitis allows you to take advantage of the benefits of eccentric work to quickly treat your tendinitis.

Let's take the example of tendinitis of the patellar tendon of the knee. The exercise may consist of positioning yourself on a muscle-building machine called "Leg extension", initially to strengthen the quadriceps. You will lift the light to moderate load with both legs (concentric phase) but you will only lower it with the injured leg.

Another example is positioning yourself on a step (or step machine), with your heels in the air. The exercise consists of going down the heel of the injured leg and then going back up using both legs.

In this way, you only work on the eccentric phase of the movement, which does not cause pain and allows you to participate in your healing. Stretching and eccentric work are therefore the basis of the Stanish protocol for the treatment of tendonitis.

Surgery as a last resort

Matériel de fitness

If, after 20 sessions of physiotherapy, you are at the same stage, the injection of PRP may be considered by your doctor. This involves taking a few millilitres of your own blood and passing it through a centrifuge to extract the platelet-rich plasma (PRP). This blood, enriched with platelets and growth factor, has healing properties. It will be re-injected into your wound with, we hope, encouraging results. On a personal note, the pain has been reduced by 50% thanks to the PRP but has not completely disappeared.

In this case, surgery may have to be considered. At the hospital or clinic, the surgeon will perform a combing. Concretely, he will make incisions in the direction of the fibres of the tendon in order to boost its reconstruction. The convalescence is long and disabling, hence the interest of not insisting on pain in case of tendonitis and of treating you immediately.

Conclusion

Today, tendinitis is easily treated. However, don't make the mistake of allowing the inflammation to take hold. If you do, you will find it much more difficult to deal with it. Prevention is crucial thanks to a quality diet, sufficient hydration, enough rest and a technique adapted to your morphology.

Once installed, make an appointment with your doctor and then your physiotherapist to start a healing protocol. We hope that this advice and my personal experience will enable you to avoid surgery, which is used as a last resort.

Cédric Jourdan
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