For years, the first line of treatment for painful tendons has been anti-inflammatory treatments such as medication and ice. However, recent studies have concluded that inflammation is not a factor in persistent tendon pain explaining the lack of results with this treatment approach. These studies have concluded that excessive loading causes weakening of the tendons structure leading to pain. These recent advances in the understanding of tendon problems have lead to the development of the EdUReP (Education, Unloading, Reloading, Prevention) model for treatment.
Following is a summary of the EdUReP approach.
- Education: The patient is educated in the basic physiology of tendinopathy as well as how their posture and activities may be contributing to overuse of the tendon. The patient and the physical therapist work together to find ways for the patient to perform activities while minimizing stress to the tendon. Kinesio tape can help "unload" the painful tendon.
- Unloading: During this phase of treatment the therapist uses patient specific strategies to minimize load to the tendon. These strategies may include external supports (braces, orthotics or taping), strengthening of other structures that may be underused or stretching of tight structures that are placing more strain on the tendon.
- Reloading: Once adequate pain control has been achieved through unloading the tendon needs to be strengthened in order for the patient to return to regular activity. One such strategy is the use of eccentric strengthening exercises discussed in our Get Eccentric” post. During this stage exercises of progressive difficulty are administered until the patient is able to tolerate the loads required for their particular activity.
- Prevention: This phase occurs once the patient is able to return to their activities pain free. Prevention may include re-emphasis of prior education as well as adaptation to technique and form. The ultimate goal is the patients independence in self-management.
Once the pain is decreased the patient is given progressive exercises to "Reload" the tendon.
Once adequate pain control has been achieved the patient is given progressive exercises to "reload" and strengthen the tendon.
The EdUReP model is a highly effective evidence based way of treating tendon problems. If you live in the Lakewood area and are interested in achieving the results we have seen with these techniques give us a call at (303) 274-2404 or email us by clicking here >>...