Tendons, which are strong and sinewy, connect muscles to bones, making them targets for mild to severe tears during periods of intense muscle stress. Successful treatment of a tendon injury depends on the degree of the damage. For the most severe tendon tears, surgery may be indicated. Mild tendon injuries often respond to nonoperative treatment, including flexibility and strength training, but moderation is the key and your level of discomfort is the best indicator of how much is too much.
Degree of Tendon Damage
Tendon injuries can occur in any part of the body but often affect the Achilles or quadriceps tendons, which are subject to impact combined with overextension of the connecting muscles. Tendon injuries or tears are classified by degree. A first-degree tendon tear is mild and will probably respond to conservative treatments; second- and third-degree injuries are more serious and require a medical examination.
Immediate Care
For all tendon injuries, immediate immobilization is essential. The Merck Manuals Online website recommends the traditional RICE method of immediate care -- resting the injured tendon, applying ice to the injury, adding compression by careful wrapping with athletic bandages, and elevating the injured limb. Immobilization is so important during the immediate or acute phase following a tendon injury that second-degree injuries should be splinted and third-degree tears may require casting.
Muscle Strength Through Flexibility
Coaches and fitness trainers like to remind athletes that “a long muscle is a strong muscle,” and in the treatment of tendon injuries, muscle flexibility is essential to the repair and recovery process. Dr. Lars Peterson, co-author of “Sports Injuries: Their Prevention and Treatment,” suggests starting with gentle stretching exercises, which "will result in greater flexibility and increased strength of the muscle-tendon unit.”
Stretching Program
Flexibility exercises targeting the muscles connected to a mildly injured tendon, can begin when the athlete’s level of pain makes stretching tolerable. Peterson recommends stretching the muscle, but not to the point of pain, holding the stretch for 15 to 30 seconds and then relaxing the muscle. This stretch is repeated five times. Peterson recommends starting slow and increasing the degree of the stretch as the muscle lengthens. The tendon can be iced after stretching if you experience discomfort.
Muscle Building and Sports Activity
Physical activity helps rebuild muscles, and for mild tendon injuries, activity can resume as soon as the pain subsides. In conjunction with flexibility exercises, you may gradually resume regular activities and sports training, but start slow and reduce activity if you experience pain. Ice the tendon afterward to lessen exercise-induced swelling.
Caution
While muscle-building exercises are an integral part of a long-term treatment plan for tendon injuries, in the case of second or third-degree tendon tears, do not start exercising until your doctor recommends doing so. Trying to build the surrounding muscles too soon could worsen the injury and increase the risk of chronic tendon pain. Peterson advises patients that “at no time should these exercises exceed the pain threshold.”
References
- Sports Injuries: Their Prevention and Treatment, Third Edition; Lars Peterson M.D., PhD.
- Merck Manuals: Sprains, Strains and Tendon Tears
