“If you think you are confronting ignorance on the track… you just have no idea!” (Charlie Francis, 22nd April, 2003, 6+ days for a marathon thread)
I am currently researching tendinopathy on the internet, and I will be posting the best links on the thread here. It is becoming apparent that the assumption that pain in tendons is tendinitis (although sometimes (rarely) it may be) may result in problems ranging from increased danger of repeating the injury frequently (chronic tendinopathy), to ending the possibility of continuing doing the activity that causes the pain.
1 http://www.tendinosis.org/ FANTASTIC SITE!
"Once people get tendinosis, it usually becomes a long-term chronic problem with no easy solution. Many people have to change careers because they can’t get their injuries to heal well enough to go back to their jobs, even if they make ergonomic improvements. They also have to make long-term changes to their daily lives outside of work to accommodate the limitations caused by the injuries. When tendinosis in an upper extremity is at its worst, people often have trouble performing even the simplest daily tasks such as opening doors, brushing teeth, shampooing hair, cutting and stirring food, tying shoes, turning pages of books and magazines, picking up children, and writing checks.
We need more research to find effective treatments for tendinosis; we don’t understand why tendons often fail to heal even after the injurious activity is stopped, and we don’t know how to reverse the damage. No current treatment has been proven to reverse the microinjuries associated with tendinosis. The injuries usually improve with time, rest, and physical therapy (and also with some nontraditional treatments), but no treatment has been shown to reverse the damage on the cellular scale. We could help many people if we could find a treatment that consistently reversed tendinosis injuries."
“By the time you feel pain from tendinosis, your injury has been gradually building for many weeks. Remember that tendons heal slowly. Dr. Khan’s article says tendons require over 100 days to make new collagen. You will probably need to wait several months before a reasonable amount of repair has occurred, so have patience with this slow healing process.”
"Non-steroidal anti-inflammatories would not be expected to help tendinosis since it is an injury of chronic degeneration, not inflammation. Studies show that some NSAIDs actually impede the healing process, which is the last thing needed with tendinosis.[17] Long-term use of NSAIDs for tendinosis is probably not a good idea. For more information, see the online articles Histopathology of Common Tendinopathies (part 4.1) and The Tendinitis Myth.[18,44] "
2 http://www.physsportsmed.com/issues/2000/05_00/khan.htm
posted on another thread already, but v. important.
3 http://www.clinicalsportsmedicine.com/articles/overuse_tendon.htm
“Failure to appreciate how pain arises in tendinopathies may be limiting progress. It is assumed that tendon overuse causes inflammation, and thus pain. We critically review the inflammatory model of pain in tendinopathy, and find that it does not withstand scrutiny. The generally proposed alternative model is that of mechanical discontinuity of collagen fibers, but this as well is inconsistent with numerous surgical observations. We review data suggesting that pain of tendinopathy may be largely due to yet unidentified biochemical factors activating peritendinous nociceptors when they are exposed to the environs as a results of tendon overuse injury. The noxious agent could include matrix substances and minor collagens. Glutamate can mediate pain, and this is present in higher concentrations in subjects with Achilles tendinopathy than controls. Chondroitin sulphate is another candidate. Examining alternative models of pain, particularly a mixed biochemical-mechanical model, may allow significant progress in management of these troublesome conditions.”