Tendon and ligament treatment

A FEW WORDS ABOUT THE DIFFERENCES BETWEEN THE TENDON AND THE LIGAMENT:

Tendon is a fibrous formation (strand), built of durable connective tissue, compact (fibrous), with a white-silver color. It consists of bunches of fibers, among which there are fibrocytes arranged in the Ranvier series. The tendon is an extension of the muscle up to the point of its attachment, and its task is to transfer the force of muscular contraction to the bone elements of the skeleton. It is durable but its elasticity is slight – it extends by only 4% of its length as a result of stretching. In the human body there are various types of tendons, including cylindrical, broad and flat, flattened, etc. Most often their shape is adapted to the structure of the muscle. In turn, its length and thickness are adjusted to the movement in a given joint, as well as to the muscle contractility.

Ligaments are bands of durable connective tissue that usually connect bones with each other, strengthening the mobile connections between the bones (joints). They can also connect bones outside the joints by stabilizing the skeletal system. They are quite flexible, but they cannot stretch too much. Among the joint ligaments there are capsular ligaments (running in the wall of the joint capsule), extracapsular and intracapsular ligaments.

Tendons, due to their function, are exposed to injuries that cause acute pain. In the case of tendon injuries, ultrasound diagnostics are used to visualize the degree of damage before applying the appropriate treatment. Relatively the mildest of tendon injuries is straining. The strained tendon is the result of microdamage of the fibers. At the time of the injury, the fibers shift too much relative to each other, thus losing coherence. A common after-effect of the tendon strain is inflammation.

Rupture of the tendon is a partial tear of parts of the tendon fibers connecting the muscle with the bone. The most common diagnosis is rupture of the Achilles tendon, rupture of the tendons of the wrist, hand and fingers. Rupture of a tendon is a trauma that does not require surgical intervention, which does not mean, however, that it is a mild injury. If the tendon has been torn once, it will be more susceptible to further injuries, including complete tear. So, if you had a torn tendon, you must exercise extreme caution during daily activities.

The injury (strain, tear or rupture) usually occurs when a movement is performed that goes beyond the physiological range of the joint. If this condition is not treated, it can cause instability, which leads to overloading and also faster wear of the joint.

CAUSES OF TENDON RUPTURE

The tendon is susceptible to damage, which is why tendon injuries happen to everyone, not just athletes. The most common cause of tendon tear is too much strain, which leads to the breaking of parts of the tendon fibers connecting the muscle to the bone. Injuries of this type are often caused by a long-term repetition of one movement.

Tendon rupture also occurs in people who have decided to take up physical activity without prior preparation (warm-up, proper training, strengthening the musculoskeletal system).

The risk of this type of injury increases during the holidays, because it is during the holidays that we often start intense exercise after months of stillness. Many of us are climbing, running, jumping and extremely strain the muscles, which makes it very easy to tear the tendon or sustain other injuries.

SYMPTOMS OF TENDON RUPTURE

Symptoms of tendon rupture are similar to symptoms of muscle rupture (inflammation, pain and swelling), the swelling in this case being usually smaller and increasing more slowly than in case of muscle tearing. There may also be bruising and hematomas due to disruption of the surrounding blood vessels and bleeding inside the tissue.

RUPTURE OF THE TENDON – TREATMENT AND REHABILITATION

In the case of tendon rupture, there is usually no need for surgery. To exclude rupture of the tendon, an ultrasound examination is performed. In the case of fresh injuries:

• Protect the tendon against undesirable movements and aggravation of the injury (it is advisable to immobilize that part of the body).
• Relieve the strain: if the damaged tendon cannot be immobilized, it should be used as little as possible, e.g. by walking with a cane, (e.g. if we have strained the Achilles tendon).
• Cool down: preferably with an ice pack (you need to remember never to put ice directly on the skin); additionally, inflammation and edema can be reduced with anti-inflammatory ointments, cold compresses (e.g. with Altacet or vinegar) anti-inflammatory drugs and painkillers.

Occasionally, conservative treatment is also carried out (the so-called orthosis is worn for a period of about 6 weeks). The traditional plaster cast is becoming a thing of the past, but in exceptional cases it may be advisable. In the case of fresh injuries of this type, the Angel System therapy works great. The application of High Concentrated Platelets extract significantly accelerates regeneration and fusion of the tendon, which is why the newly created tissue does not scar and limit the tendon flexibility and strength. In the case of long-lasting tears, where the inflammation has already occurred, it is more helpful to use the Orthokine therapy, which leads to suppression of inflammation, while allowing self-regeneration of the damaged site.

The complete rupture of the tendon is, however, a total break in the continuity of the tendon fibers connecting the muscle to the bone. The tear usually occurs as a result of an extreme strain or hitting a tense tendon (e.g. a kick). The cause may also be another condition, e.g. degenerative disease. Tearing a tendon is manifested by: pain which increases during movement, swelling and immobilization at the place of injury, sometimes even an audible crackle at the time of the injury. There may also be damage around the joints, ligaments and articular cartilage.

In the case of complete tendon rupture, surgical treatment is usually necessary to reconstruct it. After this type of injury, rehabilitation is also used. Most often these are active-passive and physical therapy exercises that last for about 6 weeks.

TENDONITIS

Another cause of tendon pain may be an inflammatory condition. Acute tendonitis can also occur as a result of a strain due to excessive exercise. It most often arises when regularly repeated effort coexists with factors such as tight footwear or incorrect posture. Tendonitis symptoms include pain intensifying during tendon action, as well as limitation of its mobility. Pharmacological treatment is long-lasting and usually does not bring the desired effect – after a temporary improvement, after discontinuation of anti-inflammatory drugs, tendonitis often returns. You should be aware that if the tendonitis is chronic, it leads to the gradual destruction of the tendon. Therefore, the Orthokine® therapy is the most effective, least straining the organism and the least invasive therapy that can be used for tendonitis.

CAUSES AND SYMPTOMS OF STRETCHING THE LIGAMENTS

As with tendons, the ligaments may suffer the following damage: stretching, straining or a complete rupture. These injuries cause inflammation, which is manifested by pain, warming of the injury site, swelling and immobilization of the joint. Stretching and rupturing the ligaments is usually the result of excessive tension in the muscles, tendons and ligaments. Injuries of this type usually occur during sports, falling down or a sprain of the joint. The basic symptom of stretching and tearing the ligaments is a hematoma inside or outside the joint. The patient develops swelling, widening of the joint’s contours, bruising around the joint (immediately after the injury or within the next few hours), pain worsening during movement, and problems with walking (if the damage occurred in the lower limb ligaments) and limited range of motion in the affected joint.

Damage to ligaments is a very common injury. If there is a slight swelling after the injury, you can move your fingers or stand on the leg, just apply cold compresses (ice or a wrap) and immobilize the site with an orthosis or elastic band for 1-2 weeks. In more serious cases (no possibility to move your fingers, visible instability of the joint) you must go to the doctor as soon as possible to perform an ultrasound scan. It will be necessary to use a stronger immobilizing cast or even undergo an operation. The time for surgical connection of the broken ligament is limited, later we can only perform reconstruction.