Physical therapy for tendinosis involves heavy resistance exercises. We no longer are dealing with an inflamed tendon. From being inflamed for more than 3 months, the inflammatory chemicals have started to breakdown the healthy collagen in the tendon. When you first damage your tendon and kill a few cells, the inflammatory chemicals are like the garbage men. They go to the area and chemically dig up and get rid of the dead cells. However, if you keep those men around too long by continuously aggravating the area, they start to chemically dig into the healthy tissues. How you have holes in your healthy tendon.
Treatment to fix the holes involves using high tension eccentric exercises, friction massage, and stretching. The goal of the eccentric exercise and the friction massage is to stimulate collagen synthesis and plug those holes in your tendon. Then we use stretching to make sure those baby cells are all lining up correctly. (read about the tooth pick analogy in the tendonitis section here
Watch this video on tendinosis and the correct physical therapy treatment approach for it.
According to research, the length of time it takes to restore normal tendon strength and plug those holes is typically between 4-6 months. However, there are “out of the box” approaches to shorten this duration and increase the rate and strength of healing.
Getting injections of prolotherapy and help speed up the process. Prolotherapy involves injection sugar into your body to stimulate inflammation and healing. It’s like using a chemical (an all natural sugar called dextrose) to purposely irritate the area. This will bring those baby cells to the area to help with healing. Typically you will need a few injections for it to work.
Another approach is to use Platelet Rich Plasma or PRP. PRP is extracted platelets from your own blood. Once extracted, the PRP is injected directly into the site of injury. The platelets provide the building materials for healing. It’s like by passing all the other steps and directly injecting the stuff you need to heal with into the area. Typically the treatment involves 1-3 injections.
If you have a pain that has been there for a long time (greater than 3-4 months) come in and let us take a look to see if it’s tendinosis. Just call us at 856-751-8881 to schedule an appointment.