resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Web Marketing: Content Is King
Google's sweeping updates to its search algorithms over the past few years have brought a paradigm shift in how you can optimize your chiropractic website to gain maximum marketing leverage.
Calcium Helps Prevent Colorectal Cancer
Over the past 25 to 30 years, studies have suggested calcium may confer protection against colorectal cancer.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
The X Factor in Clinical Research: The Patient
It was the great baseball legend, former New York Yankees catcher Yogi Berra – he of countless aphorisms, each with a mind-bending twist – who once declared, "You can observe a lot by watching."
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Saying No to Medicine
An interesting article recently appeared in Men's Journal titled "When to Say No to Your Doctor." The article begins with the summary statement above and effectively arms readers with information that will help them "take more responsibility for your own health care, because you can't be sure anyone else is.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Understanding and Identifying Pediatric Growth-Plate Fractures
In general, fractures in children heal well with little intervention as long as the alignment is good. Fractures involving the growth plate, however, are a different issue. In fact, growth-plate injuries are the primary reason for the subspecialty of pediatric orthopedics.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
5 Ways to Occupy Occupational Health
Despite the progress that has been made to better protect workers, occupational health and safety remains a priority area for many national governmental organizations due to the widespread problem of occupationally related morbidity and mortality.
Help Patients Achieve Optimal Vitamin D Levels
Much research has been done on vitamin D levels and their impact on health; optimal levels have been correlated with a reduced risk of developing numerous conditions.
Transparency and Accountability: Q&A With the CCE
Every profession needs an organization dedicated to upholding the quality and integrity of its degree programs and educational institutions.
Talking to Patients About Healthy Aging
I've noticed that a particular category of patients seems to make up more and more of my practice – they work out, but still experience lots of degenerative joint disease (DJD) issues.
Blaming the Gluteus Medius, Overlooking the Deltoid
The gluteus medius (Gmed) is commonly written about, strengthened and blamed for many conditions, and rightfully so. After all, the Gmed plays a role in pelvic stability, hip motor control and lower-quarter dynamic movements.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
July, 2001, Vol. 01, Issue 07
When Is It Tendinitis?
By Whitney Lowe, LMT
Tendinitis is one of the most common diagnoses for soft tissue pain resulting from repetitive motion. As repetitive motion disorders have dramatically increased, so has the incidence of tendinitis.However, recent investigations into the cellular nature of tendon pathologies have brought forth interesting discoveries that may alter the way tendinitis is treated. In this month's column, let's take a look at some of these fascinating discoveries.
The first stop along the way is to take a closer look at the anatomical and biomechanical characteristics of tendons. Tendons are connective tissue structures that are primarily composed of collagen and elastin fibers. Collagen fibers primarily give the tendon its strength, and elastin fibers give it a small amount of flexibility.
Since the tendon fibers are primarily designed to transmit a strong tensile (pulling) load from the muscle directly to the bone, the tendon is not designed to be very flexible. If it were very flexible, much of the muscle's contraction force would be absorbed by the tendon and not transmitted to the bone. It would be like trying to pull a heavy object across the floor with a bungee cord instead of a rope.
The tendon gets its strength not only from the quantity of collagen fibers it contains, but also from the arrangement of the fibers. In tendons, the collagen fibers are arranged mostly in a parallel direction, in line with the direction of the muscle fibers. This arrangement will give the tendon the greatest amount of strength in the direction that the muscle fibers are pulling. Ligaments, on the other hand, have a greater quantity of elastin. In ligaments, the collagen fibers are arranged in a slightly more random fashion to give the ligament strength against forces in several different directions.
Tendons throughout the body are surrounded by a thin connective tissue membrane called the paratenon. The paratenon is primarily designed to reduce friction forces between the tendon and other surrounding structures.7
Tendons in areas such as the distal extremities are exposed to much higher friction forces, as the tendons bend around the joints and are held closely by retinacula. These tendons are surrounded by an additional connective tissue layer called the epitenon. The epitenon is commonly referred to as the tendon sheath. Keep in mind that not all tendons have the tendon sheath, only those exposed to specifically high friction forces against adjacent structures, like a binding retinaculum. In some instances, an inflammatory condition will develop between the tendon and its sheath. This usually occurs from excessive friction. Adhesions may also develop between the tendon and the sheath. This condition is called tenosynovitis. However, in order for tenosynovitis to be present, the tendon in question must have an epitenon (sheath).
In some instances a diagnosis of tenosynovitis may be made because of an observed fibrous adhesion between the tendon and the paratenon but there is no tendon sheath. This happens commonly with the Achilles tendon.3 It does not have a synovial sheath (epitenon) but its paratenon is quite visible. Degeneration or adhesion of the paratenon or tendon fibers in this instance is not tenosynovitis. For many years, the term tendinitis has been used to describe painful overuse conditions of the tendon. It has been thought that the pathology involved the tearing of individual tendon fibers and a subsequent inflammatory response in the tendon. Treatment, therefore, has focused on the inflammatory nature of the problem. However, a number of recent scientific investigations into the nature of overuse tendon injuries have painted a very different picture.1,2,5,6
In these investigations, most tendinitis complaints have been found to be devoid of inflammatory cells. It appears that tendon fiber tearing is not the primary part of the problem. The main problem in these overuse tendon disorders appears to be collagen degeneration from overuse. It has also been suggested that this would explain the frequent lack of success in treating tendinitis complaints with anti-inflammatory medication. Numerous authors and clinicians have suggested that the term "tendinosis" (literally meaning "pathology of the tendon") is a much more appropriate term than "tendonitis," which specifically indicates inflammation.
So what does this mean for the treatment of tendinitis with massage? The good news is that these findings are an even stronger support for the benefits of massage for treating these overuse tendon injuries. Collagen degeneration is a primary part of most tendinosis pathology. Therefore, what is needed is a treatment that can help stimulate collagen production in the healing process.
Interestingly, several recent studies have found that the primary benefits of deep friction massage may be the stimulation of collagen production in damaged tendon fibers, rather than the breaking up of fibrous scar tissue in chronically inflamed tendons as previously thought.4 We have known clinically for years that massage works well in the treatment of tendinosis; now we may be closer to understanding why.
Click here for more information about Whitney Lowe, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.