Tendons attach muscle to bone and help the joints move fluidly. They are made of different types of collagen. When injured, tendons have difficulty healing because they are poorly vascularized. The tendon will attempt to heal itself by laying down collagen that is not as strong as the original tendon fibers, which can create thickening and pain over time.
An injury to tendons can take up to 10 weeks to try to heal. In the initial 10 weeks of healing, patients are diagnosed with tendonitis. When the healing process is prolonged, or the tendon appears thickened on imaging, such as MRI, patients are diagnosed with tendinosis or tendinopathy. Tendinopathy is a mix of tendinitis and tendinosis. Tendinosis typically refers to tendons that have chronic inflammation resulting in tendon thickening.
There are many treatment options available. Initially, treatment should be focused on conservative options such as physical therapy and injections to reduce pain. Some physicians will offer cortisone injections into the tendon. We caution our patients on these type of injections because they may weaken the tendon and sometimes tear the tendon over time. There is some evidence that supports eccentric based exercises, supervised by a formal physical therapist, that may remodel the tendon and improve pain. More advanced tendinopathy may be treated surgically, but this is rare due to expense and may result in only some improvement in patient symptoms.
At Regen Orthopedics, we offer platelet rich plasma and stem cell injections for tendon injuries. This is a procedure in which we use your own adult stem cells and inject them into the injured area. Although both tendinitis and tendinopathy respond well to treatment with these biologic injections, injuries treated early tend to respond faster. These injections into and around tendons have the benefit of increased ability to heal, decreased healing time, and decreased re-injury rate. By injecting autologous stem cells into and around the tendon, the body can regrow stronger tendons by increasing “normal” collagen growth instead of “weaker” collagen growth.
For more information or to make an appointment call 844-786-2355.