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Tendon injuries--practice tips for GPs
1Orthopaedic Research Institute, University of New South Wales, Sydney, New South Wales. pao_26@hotmail.com
Background:
Tendon injuries are common, generally degenerative in nature, and can cause significant morbidity if not appropriately managed.
Objective:
This article outlines some key principles about tendon injuries with a particular focus on diagnosis and management.
Discussion:
Diagnosis is made primarily on history and examination with imaging prescribed for unusual or recalcitrant cases. Examination elicits local tendon tenderness, pain with passive stretch, and pain with active contraction or specific provocative tests. Treatment involves pain control and musculotendinous rehabilitation. Pain control may include the application of ice, bracing and medications. Exercise rehabilitation is the mainstay of treatment for chronic tendon injuries and must include stretch and strengthening exercises. Generally, strengthening exercises for tendon injuries are eccentric in nature and should be performed relatively pain-free. Injectable modalities may be used as an adjunct to decrease pain and facilitate exercise rehabilitation, but should not be used in isolation.
