“I have had tendonitis for 6 months. Why does it still hurt?”

Let’s first quickly discuss tendons. By definition, a tendon connects muscle to bone and transmits the force the muscle produces. So, anywhere there is a muscle, there is a tendon. Common sites of tendon injuries occur at the ankle (Achilles), knee (patellar tendon), shoulder (rotator cuff), and elbow (golfer’s, tennis). Most often, tendinitis results from overuse/inadequate recovery, a drastic change in intensity or type of activity, or biomechanical issues.

By definition, the ending “–itis” refers to inflammation. Inflammation is the 1st stage of healing, but often gets a bad rap. Inflammation is good and necessary; without it, the body cannot heal itself. The problem arises when the body gets stuck in the inflammatory phase and there is improper healing.

So, tendinitis describes a recent injury that is less than a week old and is often the result of overuse or a change in the type or intensity of activity. Simply refraining from the painful activity can typically resolve the symptoms. However, many will “push through” the pain and the condition worsens to the point they can no longer perform the activity they love. Unfortunately, this is when most seek medical attention and physical therapy.

Left untreated, the structure of the tendon changes, becoming less effective at transmitting forces, which creates pain. Under microscope, the once shiny, white healthy tendon will now look brown and “gunky”, a sign of degeneration. This “chronic inflammation” of the tendon is termed tendinosis.

What does this mean? If it is true tendinitis and just started hurting this week, return to activity is much quicker if you stop doing what hurts. If this has been an issue for some time, the recovery process will take longer. So, the distinction between tendinitis and tendinosis is important and will change the treatment plan and prognosis.

At Propel Physical Therapy, we typically treat tendonitis with relative rest – cycling instead of running, etc., decreasing exercise intensity – basically, if it hurts, don’t do it. Gentle, pain-free stretching is usually sufficient to help the tendon fibers re-organize.

Unfortunately, most people do not seek medical help and physical therapy until the issue is now tendinosis. The good news is this is treatable and you will be able to return to activities you enjoy.  At Propel Physical Therapy, we utilize a variety of treatments based on the current research evidence and years of clinical experience. Various manual therapy techniques, dry needling, and a specific type of exercise targeting the specific tendon have been shown to be the most beneficial.  The video above demonstrates Eccentric Exercise for Achilles Tendinosis.

If you fall into one of these categories, please contact us at Propel Physical Therapy to see how we can help you keep moving forward.

Do you have neck pain?  Low back pain?  Shoulder pain?  While it is important to address issues at the local site of pain, it is equally important to look at the link that connects each of these areas – the thoracic spine (t-spine for short).

The spine is made up 3 regions: cervical (neck), t-spine (mid-back), and lumbar (low back).  If the t-spine is stiff, the adjacent regions will have to move more to achieve full motion…it’s the old adage, you are only as strong as the weakest link.  For example, when reaching overhead to grab a coffee cup or lift a weight overhead, if the t-spine is stiff, the shoulder will be unable to reach all the way overhead (just slouch and see how high you can raise your arms) so the low back will arch more to gain extra overhead motion.  In this example, you can see how the t-spine links the shoulder and low back.  Additionally, the neck will have to move through a greater range of motion if the t-spine is not moving well.  Again, slouch and see how much farther you have to lift your head to see an object.  In these 2 examples, the neck and low back have to move to the limits of their respective motion, which places them at greater risk of injury.

There are numerous ways to improve t-spine motion.  Most of us, myself included, sit too much and let gravity win by slouching, especially when working on the computer (I just sat up straight).  This places the t-spine in a rounded position – flexion.  Typically, we need to move the t-spine the opposite direction – extension.   There are many ways to achieve this, but the following video is one easy way to accomplish the task of increasing t-spine mobility.

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Chris and I have spent 3 years, talking, planning, dreaming and praying about opening our own Physical Therapy clinic in NW Houston. We wanted to service the community we have called home for the past 10 years – (Cypress, Tomball, Champions, Spring) and took a lot of time looking to find a convenient location. We finally settled on opening up right in the middle of them all at Highway 249 & Spring Cypress, in the Sprouts Farmers Market shopping center.

Prior to opening Propel, Chris worked at Texas Sports Medicine Center in Tomball, Texas and was privileged to work for nearly a decade in a high volume clinic.  This helped him tremendously to learn how to a treat an abundance of ailments from doctors all over the country, from total knee rehabs, return to sport programs, shoulder recovery, surgery prevention and much more. His desire to get each patient back to health safely and quickly no matter if they were a professional athlete or a retiree, drove him to learn the latest treatment techniques to ensure he was giving the best care possible. He has (and still) spends countless hours to continue his education. He thoroughly enjoys taking time to get to know patients personally, answering any questions or concerns they have with their condition, as well as customizing options of how they can help recover from each and every injury.

A few years ago, Chris started to see that spending one-on-one time with each patient was invaluable, providing time to listen and implement treatment strategies.  He began to feel that seeing multiple patients at once was hindering the quality of care that his patients so deserved.  It weighed on him heavily. There had to be a better way.  So began the dreaming and planning that led to opening Propel Physical Therapy.

He and I both hope and pray that every person who comes through our door will experience top-notch, personal and affordable outpatient physical therapy/rehab at Propel.  We want you to have a different kind of healthcare experience when you are here.  We want you to know that your care and quick recovery are our greatest concern.  We’re ready to move forward in this sometimes crazy world of healthcare and do something different.