Do I Need Tendon Surgery?
Surgery is a Last Resort
Not every tendon injury requires surgery.
It's generally understood by doctors and surgeons that surgery will introduce more scar tissue into your joint. This added scar tissue will be problematic, requiring visits to the PT clinic and often significant treatment post-surgery. If not dealt with properly, you could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.
If You Haven't Done So Yet, Get a Proper Diagnosis
Some serious cases of tendon injury may be considered as Surgically Necessary (SN) and will require surgery. IF infected, which can be very serious, you will most likely require antibiotic medications as well as surgery. This is why it is important to get to a physician and find out what is really going on - this is known as getting a proper diagnosis. Getting a proper diagnosis would also determine if your pain is a side effect from another condition or disease (Lyme disease is one example). This is less common but nonetheless, very serious. So yes, it is important to get a proper diagnosis.
The Good News
Most cases of tendonitis are not Surgically Necessary, and will heal on their own. This is why most doctors, physicians and orthopaedic specialists will recommend conservative treatments for non-SN tendon injuries before considering surgery.
Some of the most effective conservative treatment methods to avoid surgery are:
- Rest - This is important for initial healing to reduce pain, swelling and inflammation in the early stage of your soft tissue injury. Too much rest can also be harmful as joint immobility can actually cause stiffening, overcompensation and atrophy (wasting away of soft tissue). This is why rest should be used when reducing initial pain and swelling, but should not be considered for more long-term conservative treatment.
- Avoid Activity that caused your injury. - While resting the area, it's also important to avoid all activities that may have caused your symptoms - including any repetitive movements (possibly work or hobby related). This may include reduced activities in your job if that has caused your injury. Continuing on with regular activities can increase the severity of your injury, turning a mild to moderate case of tendon strain into a downward spiral of atrophic damage that may eventually severely impact your life. Also, trying to 'work around' your injury will eventually give rise to over-compensation injuries in other areas of your body.
- Use a Cold Compress or Ice Pack - Cold is very effective at reducing pain and inflammation - use at the onset of the injury and during flareups.
- Use Circulatory Boost (T•Shellz Wrap®) - After swelling and inflammation has been reduced. You can use your own blood flow to maximize your rehabilitation, maintain healthy blood flow to your muscles, tendons (and other surrounding soft tissue), decrease recovery time, and boost overall long-term healing. Promoting blood flow to the injury will help to minimize the growth of scar tissue, increase flexibility and help prevent atrophy.
- Rehabilitative stretching under supervision of a PT or doctor. The intent of this is to provide you with increased range of motion, pain relief and strengthening of the surrounding tissue of the joint. Caution: aggressive PT (such as aggressive stretching or massage) can be harmful - when dealing with a joint that has very limited range of motion, there is high risk to further damage weak and damaged soft tissue. This could lead to the need for surgery, and this is why you need to seek out a PT or physician as they can determine safe stretching parameters for you.
- Stretching - Stretching your joint in PT and at home will help you to regain your range of motion much faster than not stretching at all. Stretching in many ways is key maintaining good Range of Motion (ROM) in your joint, and stretching can be made much easier with use of a T•Shellz Wrap® before to warm up soft tissue, and a Cold Compress or Ice Pack treatment after to prevent any return of swelling and inflammation.
Restricted Movement Is Risky If It Goes On For Too Long
For acute (new or recent) Achilles tendon tears that have the ability to heal on their own - your doctor may even cast your foot in a toe pointed position (in something called a "hanging enquinus cast") or in a removable brace/splint. A removable splint can be very helpful to prepare you for PT sessions and mobility exercises.
Prolonged use of a cast, removable splint, or long-term rest (restricted movement) without proper exercise or stretching can make your Achilles tendon injury worse. If your Achilles tendon remains completely immobilized and at constant rest, the ends of the Achilles tendon (where it attaches to bone or other muscles) will begin to fill in with scar tissue as part of the healing process. You may also have on-going symptoms of pain, swelling and inflammation, and even poor blood flow circulation.
Lack of proper blood flow and growth of scar tissue will decrease the natural length of the tendon (atrophy) and tighten tissue, reducing the flexibility between your ankle and foot. Your ability to push off with your foot in certain activities such as running, jumping, or going up and down stairs all become compromised. You are also at an increased risk of re-rupture of the tendon, especially if the initial injury was large and required surgery in the first place.
What Happens When You Are Not Using Conservative Treatment Methods (as Outlined Above)
Painful soft tissue injuries such as tendinitis, tenosynovitis, tendinosis and bursitis are all injuries that cannot really be ignored. If you choose to ignore the injury, then this means you will still be be trying to do certain tasks (ie. using a fork, putting on your seat belt, etc) using soft tissue (strained and/or partially torn ligaments & tendons) that is already compromised. This means it will inevitably get worse.
Here is what to expect:
- Since the tissue is probably inflamed, lack of proper blood flow will drop your healing rate to a crawl.
- Continually straining the soft tissue (just by doing daily tasks such as walking, cooking or driving) worsens the injury and will introduce more scar tissue.
- Increased scar tissue buildup will tighten the soft tissue in your joint, decreasing your already limited flexibility (reduced range of motion). After a week or more of limited flexibility in the joint, you may start to experience atrophy - a wasting away of soft tissue that inevitably weakens the joint.
Trying to use your joints once they have not been used for a week or more can easily introduce more scar tissue, cause pain, freeze you up again and happen again and again... As you can see this is a cycle that just gets worse and worse, eventually becoming a chronic (long term) injury. This is the cycle you need to stop or you will probably wind up having surgery once your injury becomes chronic. This is why you need to treat your injury with the T•Shellz Wrap® every single day, at least twice per day.
What Are the Two Biggest "Gotchas" When Treating Tendonitis Using
Conservative Treatment Methods?
The Absence of Pain Does Not Mean Your Injury is Gone
After most of our clients use a Cold Compress or Ice Pack for a couple days, pain will typically drop very significantly. This where most people wrongly associate the pain with the injury, whereas in truth, almost all of the pain really came from the inflammation and swelling. Once the inflammation is gone, do not assume you are fully healed.
Time Is Not Your Friend
So you have used a Cold Compress or Ice Pack on your tendon injury and most of the pain is gone, but it's been a couple of months and the injury keeps flaring up. If this is you, then you probably know why this is happening now... the injury was never full healed. To really heal a tendon injury, you really need to rest until it is healed, and you don't need me to tell you this is a pain in the butt! This is why we feel the TShellz Wrap is such an important tool. It is intended to augment your body's ability to heal; if you can recover quickly, you are more likely to avoid getting into a chronic re-injury cycle.
When the swelling has gone down and the pain has reduced, you can provide pain relief and improve your joint function by using an T•Shellz Wrap® to increase blood flow to the area. Gentle massage around the injured area or small movements (if not painful) will also help increase blood flow, oxygen and nutrients and will prevent stiffness. We also highly recommend that our clients treat themselves with the TShellz Wrap wrap first thing in the morning before getting out of bed. This is important, as heat is known to increase elasticity and flexibility of soft tissue; flexible soft tissue will be less likely to strain and tear at their most vulnerable time - after a long period of inactivity.
Why Your Tendon Won't Heal
If our body is designed to heal our own injuries, why does it take so long to heal?
When we have an injured ligament, muscle, tendon or bursa, this means the tissue is damaged at the microscopic level. Your body responds to this damage with healing right away. During this healing process the injured tissue spasms. These spasms are contractions, and are meant to hold the tissue still to prevent any further injury.
Swelling and inflammation is your body's way of:
- Creating localized pain to tell you something is wrong there and to stop moving it, and
- Sending blood to the area to start healing. Healing at this point will also expand the blood vessels in the injured tissue - they enlarge and swell causing you pain. This pain is a signal for you to lessen activity that would put more undue stress on your tendon.
However, there is a significant problem with swelling and inflammation when it comes to the body's healing rate. Once soft tissue (such as your supraspinatus tendon) is inflamed, blood-flow is restricted. The body heals itself by sending nutrients through the blood to the injured tissue, and if the injured tissue is swollen, the blood-flow is greatly decreased.
Decreased blood-flow to injured tissue prevents the damaged tissue from healing as fast as it would if the area wasn't swollen.
The other issue is that swelling is also very painful. With many conditions such as the common supraspinatus tendinosis, once you get rid of the inflammation, a lot of the pain will disappear as well.
Once the Pain is Gone, We Think Our Soft Tissue Injury is Healed.
So we start using it more and more for common tasks, and then "boom" we get a sharp pain and then it starts all over. When this happens, the injury was never fully healed - and now it is worse! More scar tissue grows in the new tissue micro-tears and well, lets talk about scar tissue.
Scar Tissue - We Need It For Kick-Starting Soft Tissue Repair
But After That It is Nasty Stuff
Tendons, ligaments, muscle and other soft tissue are all meant to be durable and flexible, ready to work and move extreme forces in everyday activities. When I say extreme force, I mean try to imagine the amount of force that your legs puts on your hip, even when you are just walking, let alone running or jumping. Most of this force is handled by tendons and when they are injured or inflamed, movement will usually result in a lot of pain.
Scar tissue grows in damaged tissue when it tries to heal; little tiny band-aids that overlap each other to bind tiny tissue tears together. With this added scar tissue, muscles & tendons & ligaments become rigid, less flexible and unable to handle the forces that it once could. From this, there is added pressure on the tendons and muscles, which can easily become inflamed once there is other inflamed soft tissue in the vicinity. If you're suffering with scar tissue now you may feel the effects with stiffness, tightness, weakness and pain in your joint. So much pain that you don't want to move it!
On-going issues with scar tissue can result in soft tissue tears and increase chances of strain to nearby tendons or ligaments (as they are now handling higher forces due to overcompensation).
Scar tissue is one of the MAIN reasons why a chronic injury has not healed and your Range of Motion (ROM) is reduced from what it once was.
Scar tissue will form fast to deal with a soft tissue injury, and this scar tissue will also attach to everything in the area, including the surrounding healthy tissue as well. This can result in a fusing together of soft tissue that shouldn't be fused together, causing extreme pain when you try to move your joint - it is literally ripping scar tissue. This is why PT is often painful - the therapist stretches the joint, forcing the scar tissue bonds to break so you can regain your range of motion.
Scar tissue is a significant problem for tendon injury sufferers - causing your injury to become chronic, and taking months or even YEARS to completely heal!
To reduce scar tissue growth, prevent further injury to the area; this is done by increasing blood flow to the area and using a warming treatment to increase flexibility and length of these tissues (this makes them less likely to injure or tear further). In our opinion, treating yourself with a Shoulder TShellz Wrap is an easy, effective way to help assist in your home recovery process by reducing risk of re-injury and minimizing growth of stubborn scar tissue.
When applied before activity or work, the T•Shellz Wrap® will also relax and lengthen your soft tissue to help improve your range of motion and prevent atrophy (tissue wasting & shortening) of your injured joint.
Overall, continued treatment with a TShellz Wrap is intended to maintain good health in your soft tissue and significantly reduce your risk of re-injury.
Have you seen what happens when you add water to a flower wilted from drought? In essence, a soft tissue injury is much like a "wilted" flower; your body wants to heal its injury, but needs lots of nutrients to do it. Blood brings new life to your tissue by delivering healing nutrients and oxygen that are vital for its survival. In addition, the blood carries away toxins and waste cleaning the area and healing it faster. Without a good supply of blood, your muscles and/or tendons simply won't heal properly.
Using a T•Shellz Wrap® will not expose you to the risk of causing further harm to soft tissue like you can when using rigorous exercise. The T•Shellz Wrap® accomplishes the goal of enhanced blood flow without the need for intensive exercise and as such reduces your risk of re-injury.
When to use a T•Shellz Wrap®:
- Once the swelling is gone (usually after applying cold compression to the injury over 24 to 72 hr period).
- BEFORE getting out of bed in the morning. BEFORE going to bed at night.
- BEFORE exercise, workouts or activity of any kind to increase joint elasticity (tendons,ligaments,muscles) and decrease the chance of re-injury.
- AFTER surgery (once the skin wound has healed over) to increase post-surgery healing rate and minimize scar tissue growth at the surgery location.
- Anytime BEFORE you feel you might undertake activity that will put significant strain on the injury area.
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Minimize Your Chance of Tendon Surgery with Effective Conservative Treatment Options
If your doctor thinks you might be able to avoid surgery by using conservative treatments, you can join our many customers who have had great success treating themselves with the powerful treatment products we offer through AidYourTendon.
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Regardless of who you are or your reasons, if you want to be proactive about properly addressing your shoulder condition and minimizing the negative impact it will have on your lifestyle, talk with your physician about incorporating the use of a Shoulder T•Shellz Wrap® in your conservative home recovery plan. We have many happy customers that have recovered from their injuries faster than even they had hoped for, and significantly reduced their pain during treatment and through the healing process.
If Surgery is Required
To learn more about how to get started with recovery after surgery, click here.
The Next Step Is Up To You!
Living with pain is never easy as it affects your entire lifestyle. Living with pain during or after an intensive surgery and lengthy rehabilitation period can be even harder! What is more important than taking your best shot at trying to heal your tendon before signing up for surgery?
Doctors and Surgeons are always improving the technologies used in surgery, and results from surgery now are much more positive than they were in the past. However, all surgeries introduce scar tissue, and recovery from some surgeries can be disappointing. If you do wind up getting surgery, know that rehabilitation at-home while attending regular clinic visits or doctor appointments is vital for your overall recovery. It is especially vital to critical joints that consistently handle extreme forces (body weight). Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor, surgeon or PT is key - and this is why you should seriously talk with your PT about maximizing your recovery by using the T•Shellz Wrap® at home once you are approved for PT.
AidYourTendon stands out in this regard as our goal is to help you keep your soft tissue healthy for the long-term in a cost effective manner. This might mean a recovery at home without the need for surgery. If you couldn't avoid surgery, then you may find our products to be very helpful during your recovery period.
We strongly believe that we can help you, and we have thousands of happy clients to back this claim. You are welcome to try our products for a 60 day period. If you are committed to following the treatments outlined in the product instructions we are very confident that our TShellz Wraps will aid you immensely. If you do not receive the benefits that countless of our other customers have experienced from our products, call us, mail the product back to us and we will provide you with a full product refund.
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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!