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tendinitis treatment cedar rapids

Cedar Rapids Tendonitis Solutions

June 26, 2017 Daily Health Tips, TendinitsDrCodyScharfComments Off on Cedar Rapids Tendonitis Solutions

Why isn’t your tendinitis getting better?  Because you don’t have tendinitis!

 

Before you run away, let me explain.  Tendinitis is an EXTREMELY common diagnosis.  The problem is that tendinitis is incredibly rare!  Unfortunately, tendinitis is one of the most overdiagnosed and misdiagnosed conditions in the body.  This means that the treatment you are receiving is not making you better – in fact, it could be making you worse!

 

Tendinosis, is most likely a term that you have never heard before.  It’s a term you will get to know if you continue to read, and may be the answer to your problem.  

 

Tendinosis was a term started way back in the 1940’s.  It is a term used to describe a non inflammatory tendon condition.  Tendinitis is a term used to describe an inflammatory tendon condition.  Tendinitis has been proven time and time again through research to be a misnomer for several reasons.  Since inflammation is the key pathological process involved with the term, while research continues to prove that there are very few inflammatory cells present in the condition, tendinosis, not tendinitis, should be the more popular term and is the CORRECT diagnosis!

 

Now some of you may be sitting there asking what’s the big deal over a simple name change.  The DIAGNOSIS has a significant impact on how the condition is treated.  Tendinitis is treated often with rest, ice, and anti-inflammatories like NSAIDs and cortisone injections.  Treatment of tendinosis is focused around manual therapy to eliminate degenerated tissue, eccentric exercise, and load management.  

 

Getting the right diagnosis from the start is a VERY BIG DEAL!  Mistreatment of either condition means, you get worse, not better.  Unsurprisingly, research has also shown that those treating tendinitis with NSAIDS and cortisone injections are actually worse off after a year than those who did not!  Why is that?

 

NSAIDS and cortisone are used to treat inflammation.  Most cases of “tendinitis” as we discussed, aren’t inflammatory!  These types of drugs accelerate degeneration and weaken tendons.  These are horrible options if you have been misdiagnosed.

 

Fortunately, better options are available for the proper diagnosis and treatment of tendinosis.  At Thrive Spine and Sport in Cedar Rapids, our office specializes in the diagnosis and treatment of overuse injuries like tendinitis and tendinosis.  We see patients daily who have failed to fix this issue with multiple providers and treatments.  If you have been experiencing pain in the shoulder, elbow, under the glutes, knee, or ankle, have been diagnosed with tendinitis, and aren’t getting better, call our office today at 319-423-0925, or schedule an appointment by clicking here.

We do hope that you have found this article to be beneficial, please share with those in need!

5 Steps To Fix Tendinitis

June 28, 2016 TendinitsDrCodyScharfComments Off on 5 Steps To Fix Tendinitis

Tendinitis may be common, but the solution to finding relief for some reason is NEVER easy!  Fortunately, fixing it can be as easy as a 5 step process!

STEP ONE:  GET THE PROPER DIAGNOSIS

Tendinitis is one of the most overdiagnosed conditions in the body!  It is also one of the most mistreated.  What research has shown over the last few decades is that tendinitis is not the tendinitis that we know.  Tendinitis is most often a DEGENERATIVE condition and rarely an INFLAMMATORY one.

This is a game changer when it comes to treatment.  The classic treatment of tendinitis with rest, ice, compression, elevation, or R.I.C.E, as the common acronym refers, could actually make you worse!  Tendinosis, a degenerative condition, is more prevalent between the 2 diagnosis’ yet less diagnosed, and treatment of the condition requires almost the exact opposite of “R.I.C.E.”  Its treatment is also a 4 step process, but doesn’t come with the fancy acronym.

It is absolutely vital that you get the correct diagnosis for the correct treatment!

For more information between the differences between tendinitis and tendinosis watch this highly informative video here.

Since we already discussed the classic treatment for tendinitis, we will finish the final four steps for fixing tendinosis, the more prevalent yet less treated condition.
STEP TWO:  REDUCE YOUR LOAD

Tendinosis, as mentioned, is degenerative.  This means the tendon is actually breaking down from overuse.  In order for proper recovery to happen a general guideline is to reduce your load by a minimum of 50%.  Each case is unique, though, so it’s important to discuss your load and current activity with your provider.

STEP THREE:  MANUAL THERAPY

As tendon breaks down, weakened, dysfunctional tendon is the result.  Adhesion is the most common, most misdiagnosed and mistreated condition in the body.  When present it also speeds of the rate of degeneration in the body by placing increased stress on muscles, ligaments, nerves, and joints.  The bad tissue has to be removed for complete resolution.  Specifically applied manual therapy is the best treatment option to break down adhesion and the degenerated tendon.

Below is a short video over adhesion.

STEP FOUR: ECCENTRIC EXERCISE

Eccentric exercise is a very specific exercise used to load a tendon.  This helps to regrow stronger, healthier tendon!  Each eccentric exercise is different for each body part.

It is important to note that this type of exercise should only be instated AFTER manual therapy has been effective at breaking down a majority of bad tissue, and it has been determined you are ready for more load to be placed on the injured area.

STEP FIVE:  BRACING

Really, this is a step that can be implemented at any time.  Sometimes bracing should be used at the onset of care.  Other times bracing is used after treatment is going slower than thought.  Depending on the amount of degeneration, tendinosis is a condition that can take more than a few weeks to cure.  Bracing helps to offer support through treatment to aid in recovery and further reduce the load being placed on the injured area.  Usually, you can get away with using a fairly inexpensive brace from a local sporting goods or department store.

Tendinitis is a real pain – often misdiagnosed and mistreated.  If you, or someone you know has been struggling to find relief from tendinitis, you may have been misdiagnosed. You should seek a second opinion.  You deserve better answers and solutions to your problem!

We do hope that you have found this post helpful!  If you or someone you know is struggling with pain and have been diagnosed with tendinitis, we encourage you to share this article with them or get a second opinion.  If you live in the Cedar Rapids/Iowa City area, we would be happy to help! 

At Thrive Spine and Sport, we specialize in the diagnosis and treatment of adhesion and overuse conditions like tendinitis and tendinosis.  Currently, we are the only full body certified Integrative Diagnosis providers in the State of Iowa.  Integrative Diagnosis is the most advanced diagnosis and treatment system for musculoskeletal pain.  To fast track your recovery, call 319-423-0925 or fill out an appointment request here.

Thanks for reading!

So You Got A Cortisone Shot!….Now What?

December 2, 2015 Daily Health Tips, Studies, TendinitsDrCodyScharfComments Off on So You Got A Cortisone Shot!….Now What?

So you got a cortisone shot.  Now what?

At least that’s the question you should ask yourself.  You see, cortisone works great at eliminating inflammation – that’s the point of the injection – but inflammation is just the result of an underlying problem.  Cortisone does nothing to fix that!  The result, as some of you may know, is having to go back multiple times for more the cortisone just to get relief.

What you may not be hearing is that while cortisone may be of benefit in pain relief in the short term, studies are now showing that patients have a worse clinical outcome when compared to patients that did absolutely nothing for their pain and injury over the course of a year.  That should be startling information for those out there that have had a cortisone injection.

If you would like to see more on this information click here.

If you are someone who is debating getting a cortisone injection, or have already had one or several, there are some very important questions that you should answer.

The most important thing being – “What is your diagnosis?”  This should be a tissue-specific diagnosis!  Tennis elbow, plantar fasciitis, and tendonitis are NOT good enough!

The next question should be, “What are you trying to accomplish by getting the injection?”  Are you looking for pain relief, or are you looking for a permanent fix?”

If you have been diagnosed with tendinitis, this may seem like a simple solution, but being that a LARGE majority of tendinitis cases are NOT inflammatory and instead degenerative, cortisone will actually make this worse, as referenced here.

This brings us back to our original question – “What is your tissue-specific diagnosis?”

If you are debating another shot, “How long do you think this one will last?”

If it’s your first, the average cortisone injection will provide 6-12 week’s worth of relief.  Some are lucky enough to get more relief than that.  People who already have had one, should expect similar results as before or less.

The last question to ask yourself should be, “What do you do after this shot wears off?”

If there was a tissue-specific diagnosis, there should already be a plan in place.  If there was no plan in place it’s time to get one!  You deserve better answers, you deserve better solutions!

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At Thrive Spine and Sport, we answer your first question!  Your body does not care what technique or treatment the provider is trained in.  It simply cares, what it needs to fix the problem!  If what your body needs is not a treatment we perform, we will refer you to where you need to be.

Thrive Spine and Sport specializes in the diagnosis and treatment of overuse and sport injuries, specifically the diagnosis and treatment of adhesion.  Adhesion is one of the most common, most misdiagnosed condition in the body causing pain, inflammation, and restricted range of motion.  Most of our patients have tried numerous providers before finding relief in our office.  If you or someone you know is currently struggling with pain, we invite you to call our office to get answers to your problem today at 319-423-0925!

Before You Get A Cortisone Shot: What You Should Know

September 15, 2015 Daily Health Tips, TendinitsDrCodyScharfComments Off on Before You Get A Cortisone Shot: What You Should Know

Cortisone.  We have all heard the name.  Some of you probably know someone who has been treated with it – It may have been you.  But what is cortisone and what does it actually do?  Could cortisone actually make things worse? Let’s dive in and find out.

The emergence of cortisone started in the late 1940’s and it was immediately heralded as the safest and most reliable means to treat pain and inflammation.  Cortisone shots very quickly became the standard for overuse injuries, like “Tennis Elbow,” Achilles “Tendonitis,” “Bicep Tendonitis” and “Plantar Fasciitis.” Cortisone remains the standard today.

Cortisone, closely related to cortisol and also produced naturally in the body by the adrenal glands in response to stress, acts to suppress the immune system resulting in reduction of inflammation, pain, and swelling at the site of injury.  Cortisone is primarily used in the short term and typical results provide several weeks to months of relief.  Sounds good, right?

Not so fast.  A recently published review examined the results of several randomized trials, involving thousands of participants with overuse injuries.  These studies did find that, in the short term, cortisone did work to relieve pain better when compared to doing nothing (no shock there) or physical therapy. But what the review also states is that when the same participants were reexamined 6 and 12 months later, not only did they have a LOWER rate of recovery than the other test group, they also had a significantly HIGHER chance of RELAPSE!

So why is this? Cortisone shots are used for the treatment of INFLAMMATION!  Overuse injuries do not involve INFLAMMATION!  More research is now showing overuse injuries (“Tennis Elbow,” “Golfer’s Elbow,” “Achilles Tendonitis,” “Plantar Fasciitis,” etc.) to be DEGENERATIVE!  That means that the tendons of the involved structures actually begin to fray with overuse.

But why does cortisone work in the short term then?  Cortisone has an undeniable effect on the nervous system.  Cortisone increases the body’s pain threshold, increasing it in the short term.  This is why you no longer have pain and can return to regular activity.  But this is also why the pain returns after the cortisone wears off! Pain is a protective mechanism of the body.  Pain is the body’s way of telling you to stop doing what you are doing.  When pain is overridden, the degeneration of the overuse injuries continues to occur leaving you worse off than when you started.

So what should you do?  With any degenerative injuries, the tendons and other soft tissues must be restored.  The best way to do this is by getting a proper diagnosis!  Far too often these injuries are misdiagnosed.

Once a proper diagnosis has been established, you can begin the right treatment for your problem.  Most often this treatment includes, manual therapy and at-home exercises.  Bracing and load management are possible options for those responding to care slower than usual. Cortisone injections should be the LAST place to start with treatment!

At Thrive Spine and Sport, we pick up where others have failed.  If you have been debating on whether or not to get a cortisone injection, and you live in the Cedar Rapids or surrounding areas, I invite you to fill out the appointment request on this page or call our office today at 319-423-0925 and get to the bottom of your pain!  If you have any questions, please feel free to reach out to Dr. Cody Scharf at dr.cody@thrivespineandsport.com.

 

Thanks for reading!

Is It Tendinitis?

September 9, 2015 TendinitsDrCodyScharfComments Off on Is It Tendinitis?

Does this sound familiar?

You develop pain, and it’s getting worse. You pull out your computer and search for what’s wrong. The search reveals “tendinitis.”

Looking at the treatment options, you decide to take a couple weeks off, ice twice a day, stretch as often as you can and take pain relievers when needed.

Things are going great, the pain has disappeared and you decide to get back to regular activity. You start your warm up. You begin to play or run, then uh-oh, the pain is back.

It hasn’t left. Now what do you do? Cortisone shot? Surgery?

Why did the pain return? The answer is simple. The diagnosis and treatment were wrong.

What we are finding now is that most cases of tendinitis are misdiagnosed and are actually tendinosis. While tendinitis is believed to be an inflammatory process, tendinosis is a degenerative one.

With return of activity and lack of proper recovery, we often see overuse of muscles and joints commonly used in that activity. With overuse, tendons and muscles become weak and degenerate. Once the muscles and structures are weak, adhesion will form to try to stabilize the area. This also alters joint motion and leads to further weakness and pain. If left untreated, this can lead to torn muscles, tendons and ligaments. Rest, ice and stretching do nothing to repair damage to injured soft tissue.

Overuse Cycle

Treatment of tendinosis takes a different approach. Try these four steps:

Manual therapy. Adhesion is the most common result of overuse. To remove adhesion, you need therapy from someone certified to treat the condition.

Eccentric exercise. When a tendon or ligament is degenerated, rest will not fix it. It needs to be regenerated and strengthened. Eccentric exercise does this by helping improve blood flow into the origin and insertion points of muscles where degeneration is common.

Load Management.  I hate the word “rest” when treating injuries, because in most cases it gives you false hope – that something is actually being fixed – when in reality it isn’t.  In tendinosis cases, rest helps the damaged soft tissue recover from treatment faster and reduces the risk of more severe injury. 97% of all soft tissue (muscle, ligament, tendon) tears happen in degenerated tissue.  This is tendinosis!

Get a brace. Using a brace reduces stress on the injured area and allows treatment to be more effective and can help speed up recovery time.

Recovery time depends on how long symptoms have been present and how much damage has been done to the soft tissue.

At Thrive Spine and Sport, we specialize in the diagnosis and treatment of adhesion, a primary cause of tendinosis and tendinitis.  If you or someone you know has been struggling to find relief from “tendinitis” it’s time to find out what’s really wrong!  You deserve real solutions to your problem.  Fill out the appointment request on this page or call our office at 319-423-0925 today!

Thanks for reading!

Is It Tendinitis?

June 23, 2015 TendinitsDrCodyScharfLeave a comment

Tendinitis and tendinosis. One you’ve probably heard before.  The other, probably not. While they both sound the same, in reality they are worlds apart.

Tendinitis is, by definition, inflammation of a tendon.  Tendinosis on the other hand is defined as chronic tendinitis and implies chronic tendon degeneration without the presence of inflammation. Basically, one is short-term with inflammation, the other long-term, without inflammation, though both are caused typically by overuse.

soccerTendinitis, the most popular diagnosis of the two, usually presents with swelling and tenderness at the sight of pain, often accompanied by stiffness, and less often by weakness. Tendinosis presents most often with stiffness, tenderness to the touch, and weakness–almost identical to tendinitis. Recovery of tendinitis lasts anywhere from days to six weeks, a relatively “quick fix.” Tendinosis recovery can last a few short weeks to a couple months or more depending on the level of degeneration. If left untreated, tendinosis often leads to “tear” injuries.

While both conditions are classically treated with conservative measures, the difference in care is absolutely critical to resolution of the problem. Conservative management stems around rest and anti-inflammatory medication for tendinitis, while conservative management of tendinosis aims to restore tendon regrowth and strength through manual therapy and eccentric exercise.

Both, occur most often in the Achilles tendon (ankle), patellar tendon (knee), proximal hamstring (high hamstring), common extensor tendon (elbow), and the supraspinatus tendon (shoulder).

With both of these problems being so relatively close, while treatment is vastly different, proper diagnosis is vital to the recovery process! So which one do you have? Let’s go to the research.

While tendinitis is the wildly over-popular diagnosis among general practitioners, it may not be the case. Most research coming out on this topic is now showing that at a cellular level, once believed tendinitis actually is, in fact, tendinosis.

According to Almekinders and Temple, “Most currently practicing general practitioners were taught, and many still believe, that patients who present with overuse tendinitis have a largely inflammatory condition and will benefit from anti-inflammatory medication. Unfortunately this dogma is deeply entrenched. Ten of 11 readily available sports medicine texts specifically recommend non-steroidal anti-inflammatory drugs despite the lack of clinical evidence.”

In light of this, chances are that if you have been diagnosed with tendinitis the diagnosis was incorrect. Furthermore, traditional, conservative treatment, of such, with the use of anti-inflammatories, corticosteroid injections, and/or pain medication may have left you worse off long term even though pain may have dissipated short term (but this conversation is for a different time). These methods were designed to eliminate inflammation, not regrow tendon. As mentioned above, treatment of tendinosis should be aimed at restoring tendon function and strength through manual therapy and eccentric exercise. Drugs will not help! Treatment should also include load management when deemed necessary.

With all this said, while we cannot assume a diagnosis was incorrect, lingering, worsening, or reoccurrence of pain would suggest that it may in fact be tendinosis. It is recommended that treatment plans geared toward tendinitis, in these cases, be reevaluated.

Tendinitis is one of the most commonly diagnosed injuries and all too many struggle to find relief. With the proper diagnosis and treatment plan, it doesn’t have to be that way!

At Thrive Spine and Sport, we specialize in the diagnosis and treatment of musculoskeletal injuries, including tendinitis and tendinosis.  Most patients have seen many different providers before finding relief in our office.  Fill out the appointment request on this page or call our office at 319-423-0925 to set up an appointment today!

Thanks for reading!