TENDON REFORM
ASTYM, the latest strategy for correcting tendinitis.
A tendinitis diagnosis refers to inflammation of the tendon, the structure that connects muscle to the bone it moves. One of the most discouraging components of this condition has to be its limiting effects.
Tendons are essential for the function of any given body part. Tendinitis in the shoulder can keep a pitcher off the mound; in the foot, a runner off the track; and in the elbow, a worker off the job. Nobody wants to limit their activity level, especially when their livelihood depends on it.
Recent research has shown that what we experience as tendinitis is actually the development and continual reinjury of small areas of scar tissue, or fibrosis, not inflammation as was previously thought. The fibers of a tendon should be lined up like strands of dry spaghetti in a box. Small, repeated injury to the tendons causes the development of scar tissue that looks more like wet noodles. When a muscle contracts it pulls on the bone through the tendon. When that force is put on the tendon that has taken on an abnormal arrangement, some of the irregular fibers can get injured, causing the production of even more scar tissue.
Knowing all of this, researchers in Muncie, Indiana, have discovered a strategy to aid the body in correcting these abnormal fibers. Augmented soft tissue mobilization (ASTYM) is a treatment performed by physical and occupational therapists, and licensed athletic trainers that stimulates the body’s natural process of tissue remodeling. By treating the tendon with specially designed instruments (much like a specific localized massage), the body is stimulated to reform the tendon back to its original structure. The treatment is usually done twice a week for 3-4 weeks.
Possibly the greatest pro of this method is that it allows the patient to maintain their normal activities. In fact, for the treatment to be most effective some motion is required. The body remodels the tendon based on the specific activity demands. Little by little, the tendon fibers that are not needed are reabsorbed, leaving the fibers that are in normal alignment to perform their function.
More information about the treatment and where to find a qualified provider can be found at ASTYM.com.
How do these instruments work (heat, electric waves, etc.)?
The process works by taking hardened, specially designed, handheld instruments and stroking them along the tendon while the therapist applies moderate pressure. The mechanical irritation of the fibrotic areas causes a local, low level inflammatory response by the unwanted segments of the tissue. As the body completes the normal inflammatory process, the tendon remodels to a more normal structure.
Are there any measures an athlete can take to prevent tendinitis?
The most significant things athletes can do to prevent tendinitis are: 1) Move with good biomechanics. Placing the body in unnatural positions or alignments during movement causes irregular stress to tendons. This is the most common cause of patellar tendinitis, and 2) Make sure the training program does not change drastically and abruptly. Sudden increases in speed, distance, weight lifting, length of workouts, training surfaces or frequency of workouts forces the tendons to perform to a level for which they are not prepared. This causes the accumulation of small injuries that result in the fibrosis discussed earlier.
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