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Fragments from Floyd



The hand specialist I saw last week was not surprised. “Massage therapists and PTs have a high occupational risk of the kind of joint damage you have” he told me “due to the frequent compressive loads on the thumbs from manual modalities like trigger point massage.” Small comfort and not news.

But we all run the risk of using our joints, tendons and muscles in ways to which they cannot adapt.

The American Society of Hand Therapists issued a consumer alert in January saying that handheld electronics are causing an increasing amount of carpal tunnel syndrome and tendinitis. With that warning, the society included directions on how to properly hold the devices, urging users to take breaks and, if possible, place pillows in their laps so their wrists are in a more upright position.

According to the Bureau of Labor Statistics, ergonomic disorders are the fastest-growing category of work-related illnesses for which it receives reports. In 1981, only 18 percent of all reported illnesses were repetitive strain injuries, known as RSI. By 1992, that figure had grown to 52 percent. link

The consequence of repetitive strain is often chronic tendon injury–previously and in apparent error referred to as “tendinitis”. -itis indicates an inflammatory condition, and it turns out that for the most part, we we suffer from is “tendinosis”.

The suffix “osis” implies a pathology of chronic degeneration without inflammation. Doctors prefer the term tendinosis for the kind of chronic tendon injuries that most of us have. The main problem for someone with tendinosis is failed healing, not inflammation; tendinosis is an accumulation over time of microscopic injuries that don’t heal properly. Although inflammation can be involved in the initial stages of the injury, it is the inability of the tendon to heal that perpetuates the pain and disability. Most of the pain associated with tendinosis probably comes not from inflammation but from other irritating biochemical substances associated with the injury.

If you want to know more, I suggest you read Overuse Tendinosis, Not Tendintis in The Physician and Sports Medicine. It does matter, because if your doctor or therapist is treating an inflammation or if you think simply taking NSAIDS (non-steroidal anti-inflammatory meds) is going to do the job, I have bad news for you.

Tendinosis is much, much easier to get into than it is to get out of. And we have scant remediation other than avoiding the offending injury (Blackberry, Nintendo or your job!) and gradually working to improve your strength and body mechanics and the ergonomics of your activities of daily living–at home and work.

3 thoughts on “Tendin-OHH!-sis”

  1. AMEN!

    I wish just one of the 6 doctors I went to over a period of a year, had been just half as knowledgeable.

    With a problem of over-use, they referred me for harder and harder physical therapy, because the normal therapy was not stressing my over used, highly developed leg muscles, enough.

    Boy it just seems elementary to me if your problem is from over-use, as they rightly diagnosed my problem to be, you don’t increase the use. To do so just magnifies the problem.

    I finally did just what you did, got on the net and researched. And even at that, there was very little accurate info available. But I gather enough info to know ankle weights and stressful exercise was not the right thing to be doing.

    Wish I’d have had you for a PT, a year and half ago.

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