Understanding Tendon Pain
Part II - Assessment of Tendon Pain/Injury
Zac Caughey
For an accurate diagnosis of tendon injury, a thorough assessment is needed. Key parts of patients’ history can help to identify the injury’s causes. To confirm the diagnosis of a tendon injury, City Baths Physiotherapists use a variety of subjective questions and physical assessments.
imPORTANT DEFINITION
Subjective assessment
Detailed athletic history is a critical component of tendon assessment. Tendon injury has hallmark signs, including:
- Tendon pain stays localised
i.e. pain is only on the area around the tendon and does not spread with taking weight onto the painful side
- History of pain coming on slowly, made worse by increased loading patterns
i.e. fast sprinting will be more aggravating and painful than slow jogging for Achilles
tendinopathies.
- Often exhibits a warm-up pattern
i.e. pain decreases with activity
It is important that your physiotherapy assessment addresses abnormal tendon pain. The following symptoms suggest a source of pain other than tendon pathology:
- sudden pain when exercising
- pain at low loads (e.g. light weights; cycling)
- pain at rest or at night
- pain that spreads out from source point under load
The final and most crucial factor in determining whether tendon pain is caused by tendon pathology is changes in training load. Changes in training load include things like increasing training frequency or intensity. Greater stresses in the lower limb of the athlete may also result from changes in the surface or shoes worn while exercising.
Objective Assessment
Confirming the diagnosis of tendon injury and excluding alternative causes are the goals of comprehensive objective tests. This is necessary to guide appropriate and efficient care. City Baths Spinal and Sports Medicine physiotherapists conduct a thorough assessment, to find areas of weakness in the athletes’ lower limb movement patterns and determine whether an increase in tendon load has resulted in tendon pain.
Our physiotherapists use questionnaires, as well as strength, endurance, and power testing, to confirm tendon pathology diagnoses. These are critical for understanding athletes’ tendon capacity and addressing deficits that may exacerbate the injury.
imaging
Athletes are often referred for imaging by their GP to identify tendon injury; but recent studies have shown that imaging alone does not confirm tendon pathology as the cause of pain. Asymptomatic athletes can also present with tendon pathology on imaging. Imaging is helpful, but before confirming a diagnosis, it is crucial that imaging results match the clinical symptoms. To identify a tendon injury, the team at City Baths Physio use extensive testing and questioning.
How early should you book your physiotherapist appointment?
Don’t hesitate if you have recently increased your activity and are experiencing pain in your tendons – you could make your injury worse!
Your physiotherapist will oversee your rehabilitation and help you return to your activity goals as safely as possible.
Why choose CBSSMC?
- Thorough assessment & accurate diagnosis.
- Rehabilitation program relevant for your sport, activity or goals.
- Clinical Pilates studio – incorporate reformer or mat Pilates into your rehab program!
- Experienced physiotherapists – we’ll find the right practitioner for you.
- Convenient Melbourne CBD location – walk, PTV or drive!
- Flexible appointments – before and after work times available.
If you think you’re experiencing tendon pain, or have been diagnosed with a tendon injury, make an appointment with one of our experienced physiotherapists today!
Stay tuned for Part III - Treatment of Tendon Injuries
Stay in touch and up-to-date via our socials!
References
- Malliaras P, Cook JL, Kent P. Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. J Sci Med Sport. 2006;9(4):304-9.
- Cook JL, Khan K, Kiss ZS, Purdam CR, Griffiths L. Repro – ducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players. British journal of sports medicine. 2001;35(1):65-9
- Moller M, Lind K, Styf J, Karlsson J. The reliability of isokinetic testing of the ankle joint and a heel-raise test for endurance. Knee Surg Sports Traumatol Arthrosc. 2005;13(1):60-71.
