Tendon injuries are common and include most regions of the body including the shoulder, elbow, wrist, hip, hamstring, knee, foot and ankle. Ligaments connect bone to bone and are treated similarly.

Tendons act like anchors and connect muscle to bone. For example, the Achilles tendon attaches the calf to the heel. Tendons are subjected to increased repetitive forces and have a poor blood supply, which make them vulnerable to injury and hard to heal. Following a new injury, the tendon is inflamed and is termed “tendonitis.” Initial treatment is focused on decreasing the inflammation with compression, ice, anti-inflammatories, and physical therapy. Unfortunately cortisone, when injected directly into a tendon, has been demonstrated to cause further damage and tearing.

Research has clearly shown that after 4-6 weeks the tendon is no longer inflamed, but rather begins to thicken and forms gaps of scarring within it. This phenomenon is termed “tendinosis.” Consider a tendon as a million fibers making up a rope. The rope gets thicker, however becomes less strong with scarring within it or occasionally calcium deposits. Therefore suppressing inflammation at this point no longer makes sense; and increasing inflammation, oxygen, and blood flow are necessary.

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