Tendons connect muscle and bone, and we don't notice them until they get damaged or injured. Healing is a slow process because of low blood supply. Recent injuries can sometimes be treated with anti-inflammatory drugs and ice, whereas older injuries, greater than 6 months, are best treated with minimally-invasive procedures, physical therapy, and high-resolution ultrasound monitoring. Dr. Berkoff is an MD, board certified in Emergency Medicine and Sports Medicine, who practices full time at UNC Orthopedics and specializes in tendon injuries. He treats amateur and professional athletes. At one time he ran a custom bike business doing professional bike fit and design, and was a cyclist and triathlete.
Glossary
acute - tendonitis is acute, onset less than 2 months ago.
chronic - tendonosis is chronic, lasting more than 6 months.
cytokine - substances secreted by certain cells of the immune system that have an effect on other cells.
deep tissue massage - focuses on deep layers with slow firm strokes - painful but can be beneficial.
degenerative tissue - a change of tissue to a lower or less functionally active form.
eccentric - stress on a tendon from the "downstroke" of a lifting exercise - painful but can restore degenerative tissue.
fenestration - poking lots of closely spaced, tiny holes. Perforation.
FIFA 11 - a warm-up program for soccer players developed by an international group of experts, designed to reduce injuries.
hamstring - one of the three posterior thigh muscles (back of thigh).
inflammation - a localized reaction that produces redness, warmth, swelling, and pain as a result of infection, irritation, or injury.
iontophoresis - uses an electrical field to deliver cortisone through the skin and into underlying tissues.
IT band - iliotibial band, a tendon that connects thigh muscle to the the tibia, the major bone in the lower leg.
Levaquin - an antibiotic medicine - like other drugs in its class, an uncommon side effect is tendonitis.
ligament - tough, flexible, fibrous connective tissue that connects bones or cartilages or holds together a joint.
microspheres - used to slowly release growth factors into tissue.
nitroglycerin - a vasodilator medicine that opens blood vessels to improve blood flow.
patellar tendon - works with the muscles in the front of the thigh to straighten the leg.
plyometrics - maximum intensity interval training.
prolotherapy - an injection to create an inflammatory response, to restart the healing process.
PRP - platelet-rich plasma extracted from patient's blood - red and white blood cells are removed.
PT - physical therapy.
quadriceps - "quads", muscles at the front of the thigh.
rice - Rest, Ice, Compression, Elevation - conventional therapy for sprains - not particularly effective.
rotator cuff tendons - provide stability to the shoulder.
sclerotherapy - procedure used to reduce or collapse veins.
shock wave therapy - a painful noninvasive treatment that uses high-energy acoustic waves.
stem cell - an undifferentiated cell capable of reproducing into specialized cells.
tendinopathy - tendon disease.
tendon - a flexible but inelastic cord of strong fibrous collagen tissue attaching a muscle to a bone.
tendonitis - acute tendon injury accompanied by inflammation.
tendonosis - chronic tendon injury with degeneration at the cellular level and no inflammation.
Tenex - a minimally-invasive procedure for removing degenerative tissue.
ultrasound - uses high frequency vibration for medical imaging and treatment.
UTC - Ultrasound Tissue Characterization Tracker - produces high resolution 3D image