17. Injuries of tendons, diagnostics, treatment

How do we exercise a tendon back?

Build back to previous level slowly and stop if it hurts. Warm up before exercise and do some gentle stretching afterward. After the activity, apply ice to prevent pain and swelling. If the injury is severe or long-lasting your doctor may have you use a splint or cast to hold the tendon still. It may take weeks or months for a tendon injury to heal. If you start using the injured tendon too soon, it can lead to more damage

What are open injuries of tendons?

By glass, knifes etc

What do complete rupture cause?

Immediate loss of function. Permanent if not repaired

What is tendinitis?

Inflammation of the tendon

When do a tendon injury happen?

It can happen suddenly, but is usually a result of many tiny tears to the tendon over time. Due to overuse or ageing. Most common for people doing the same motions over and over in their jobs, sports etc are more likely to damage a tendon.

What do we need to do if there isn't enough healthy tendon to reconnect?

Surgeon can preform a tendon graft using a piece of tendon from another part of body. It may be from the foot or toe. A tendon transfer (moving a tendon from one area to another) may be useful in restoring function

What is the term for inflammation and micro tears of tendon?

Tendinopathy

What are closed injuries of tendons?

Tendons snap if overstressed in sports and other physical activities

How can we treat a tendon injury at home?

Rest painful area, avoid any activity that makes the pain worse Apply ice or cold packs for 10-15 min at a time, as often as 2 times an hour for first 72 course. Keep using ice as long as it helps Take over the counter pain relievers Do gentle range of motion exercises and stretching to prevent stiffness

What may be injuries in open injuries of tendons?

Single or multiple tendons, nerves, blood vessels and bone.

What is a non-surgical treatment of tendon injury?

Splinted for 4 weeks, 12 weeks to full strength

What are some examples of tendon injuries?

Achilles tendon rupture during muscle contraction Patellar ligament rupture when trying to prevent fail

How do we diagnose tendon injuries?

Loss of function e.g. on finger. More problematic when there are ligaments with more functions. Partial lacerations are not obvious unless they cause pain

What will a surgeon do to repair a tendon?

Make one or small incisions in the skin over the damaged tendon Sew the torn ends of tendon together Check if there are injuries to surrounding tissue, such as injury to blood vessels or nerves Close the incision Cover the area with sterile bandages or dressings Immobilize or splint the joint so as to allow the tendon to heal

Where do most tendon injuries happen?

Near joints, such as shoulder, elbow, knee or ankle.

What are symptoms of tendon injury?

Pain (get worse when using tendon) Stiffness Loss of strength in the affected area Area may be tender, red, warm and swollen if there is inflammation You may notice a crunchy sound or feeling when you use the tendon

How do you asses a tendon injury?

Position of laceration Posture when relaxed Passive movement to check resistance and stability Active movement is when we ask patient to flex, extend, adduct, abduct or rotate affected joint

What do we need to do after surgery?

Protected mobilisation until strength is recovered

What is tendosis?

Tiny tears in the tissue in and around the tendon caused by overuse

What are tendons?

Tough fibres that connect muscle to bone. E.g Achilles tendon connects the calf muscle to the heel bone.

What happen when we do nothing after a tendon injury?

Unrepaired tendons contract Muscle shortens and atrophies Tunnels which tendons run through will shrink Joint stiffness