Back Clinic Injury Care Chiropractic and Physical Therapy Team. There are two approaches to injury care. They are active and passive treatment. While both can help get patients on the road toward recovery, only active treatment has a long-term impact and keeps patients moving.
We focus on treating injuries sustained in auto accidents, personal injuries, work injuries, and sports injuries and provide complete interventional pain management services and therapeutic programs. Everything from bumps and bruises to torn ligaments and back pain.
Passive Injury Care
A doctor or a physical therapist usually gives passive injury care. It includes:
Acupuncture
Applying heat/ice to sore muscles
Pain medication
It’s a good starting point to help reduce pain, but passive injury care isn’t the most effective treatment. While it helps an injured person feel better in the moment, the relief doesn’t last. A patient won’t fully recover from injury unless they actively work to return to their normal life.
Active Injury Care
Active treatment also provided by a physician or physical therapist relies on the injured person’s commitment to work. When patients take ownership of their health, the active injury care process becomes more meaningful and productive. A modified activity plan will help an injured person transition to full function and improve their overall physical and emotional wellness.
Spine, neck, and back
Headaches
Knees, shoulders, and wrists
Torn ligaments
Soft tissue injuries (muscle strains and sprains)
What does active injury care involve?
An active treatment plan keeps the body as strong and flexible as possible through a personalized work/transitional plan, which limits long-term impact and helps injured patients work toward a faster recovery. For example, in injury Medical & Chiropractic clinic’s injury care, a clinician will work with the patient to understand the cause of injury, then create a rehabilitation plan that keeps the patient active and brings them back to proper health in no time.
For answers to any questions, you may have, please call Dr. Jimenez at 915-850-0900
Can bone growth stimulators help promote bone healing in cases where fractures or fusions fail to heal properly?
Bone Growth Stimulator
Individuals who sustain broken bones typically heal the fracture with appropriate treatment, which may include casts, realignment, and surgery. This type of surgery is performed on the spine and joints throughout the body; typically, the bone heals without a problem. Bone healing is a natural process, as bones are constantly replaced with new ones, and after an injury, the body can heal the damage to the bone. However, bone healing sometimes does not happen correctly and/or completely. Bone healing can take a long time, which is known as a delayed union, or it may not occur at all, or a nonunion. This is when a healthcare provider could recommend bone growth stimulation.
How They Work
Bone growth stimulators apply external or implanted electrical or ultrasonic energy to the fracture or fusion site, stimulating bone growth. These devices are often used when a fracture doesn’t heal within the expected timeframe (a nonunion fracture) or when a spinal fusion has not successfully fused. (FDA, 2022)
They come in various shapes, sizes, and technologies depending on the location of the fracture.
The most commonly used bone stimulators in orthopedics are electrical and ultrasound stimulators.
The stimulator emits a pulsed electromagnetic or ultrasonic impulse to the area where bone healing should occur.
Most modern bone stimulators are attached near the fracture site or fused with a small battery pack and worn for a period each day that may last minutes or hours.
Electrical Stimulation
Devices deliver low-level electrical pulses to the fracture site, which can stimulate bone cells to create new bone tissue.
Ultrasound Stimulation
They emit low-intensity pulsed ultrasound waves, which are absorbed by the bone and can promote bone healing.
Implantable vs. External
Some stimulators are surgically implanted, providing constant stimulation directly at the fracture site, while others are external and worn over the skin or cast.
The goal is to activate a series of receptors in the body to encourage a healing response. (Childs, S. G. 2003) The stimulator activates a pathway that releases chemicals within the body to promote fracture healing. This type of process in the body is called a cascade, and it happens when one signal stimulates another method, and so on until healing is complete. The bone stimulator ensures this cascade continues until the healing process is complete.
Effectiveness
Studies of bone stimulator effectiveness suggest two benefits:
Less pain is associated with the bone healing process.
Faster fracture healing.
However, these studies haven’t shown that these differences lead to improved patient functional outcomes. It would seem that if there is less pain and faster healing, then the patient should recover without complications. However, some researchers have suggested this is probably because the differences in pain and healing times are small and not necessarily noticeable. (Aleem, I. S. et al., 2016)
While bone growth stimulators can be effective, the results can vary, and their effectiveness is still under investigation.
Some studies have shown that stimulators can reduce pain and speed up healing time, while others have shown mixed results.
It’s important to discuss the benefits and risks of bone growth stimulation with a doctor to determine if it’s the right treatment option.
When Stimulation is Necessary
Bone stimulators are currently not used for routine fracture healing. It is certainly possible that bone healing stimulators will be used routinely in the future. They seem to show some benefit in non-healing fractures or fractures that are likely troublesome to heal. Some reasons individuals may have problems healing fractures are injuries to the blood supply to and around the fracture, injuries to specific bones, and overuse-related fractures. (Victoria, G. et al., 2009) These injuries may include (FDA, 2022)
Nonunion Fractures
When a fracture doesn’t heal within the expected timeframe.
Open fractures
Stress fractures
Scaphoid bone fractures
Talus fractures
Failed Fusions
When a spinal fusion hasn’t been successful.
High-Risk Patients
For individuals with factors that can hinder bone healing, such as smoking, diabetes, or certain medications
Bone healing typically proceeds without much problem. However, there are situations where people have issues healing after fractures or surgery. Bone stimulators are not used for routine bone healing but in situations where steps may be needed to help stimulate the body. While the improvement may be small, it may be critical if it is the difference between healing and nonhealing.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Aleem, I. S., Aleem, I., Evaniew, N., Busse, J. W., Yaszemski, M., Agarwal, A., Einhorn, T., & Bhandari, M. (2016). Efficacy of Electrical Stimulators for Bone Healing: A Meta-Analysis of Randomized Sham-Controlled Trials. Scientific Reports, 6, 31724. doi.org/10.1038/srep31724
Victoria, G., Petrisor, B., Drew, B., & Dick, D. (2009). Bone stimulation for fracture healing: What’s all the fuss?. Indian Journal of Orthopaedics, 43(2), 117–120. doi.org/10.4103/0019-5413.50844
For individuals dealing with or experiencing muscle pain and stiffness, how long does it take to loosen tight muscles?
Length Of Time to Loosen Tight Muscles
Tight muscles are often caused by overuse or strain, combined with muscle soreness, a common symptom of tight muscles. The soreness peaks around the third day and begins to subside, typically resolving within a few days. But if tightness persists or is accompanied by other symptoms like numbness, inability to move, or swelling, it’s important to consult a medical provider. (Spine Medicine and Surgery of Long Island, 2024) However, it can take much longer for individuals who have never stretched and have had tight muscles for years, depending on the severity, injury history, and underlying causes.
Factors Influencing Timeline
Consistent stretching can take anywhere from a few weeks to a few months to noticeably loosen tight muscles and improve flexibility. The specific time frame depends on factors like the severity of the tightness, underlying causes, and individual consistency with stretching. (Peterson Physical Therapy, 2024)
Severity of Tightness
Muscle knots and significant limitations in range of motion may take longer to resolve than minor stiffness.
Underlying Causes
If tightness is due to a specific injury or condition, addressing that cause is important for lasting and maintaining improvements. (Healthline, 2023)
Individual Factors
Genetics, age, and overall health can influence how quickly muscles adapt to stretching.
Consistency
Regular stretching, ideally daily or several times a week, is essential for feeling progress. (Mayo Clinic, 2023)
Stretching Routine
The length of time can vary based on the starting flexibility level and the specific stretching routine. (Mayo Clinic, 2023) It typically takes several weeks of consistent stretching, at least 3-4 times a week, to notice flexibility improvements. Longer-term changes, beyond the initial feeling of being looser, usually take 8 to 12 weeks.
Longer holds (1-2 minutes) can provide deeper benefits.
Long-term Gains
For substantial and sustained improvements, stretching consistently for several months is recommended. (Mayo Clinic, 2023)
Initial Changes
Individuals may notice small improvements in the first few weeks, especially starting from a more inflexible position.
Influencing Factors and Results
Individual genetics, current flexibility level, and the specific exercises can affect how quickly improvements are seen and felt. (Peterson Physical Therapy, 2024)
What To Expect
Improvements
Within a few weeks, individuals might notice a decrease in the sensation of tightness or increased ease in reaching a stretch. (Peterson Physical Therapy, 2024)
Longer-Term Changes
Significant muscle length and flexibility improvements may take several weeks to months of consistent effort.
Consider professional guidance for specific concerns or limitations. Consult a physical therapist or healthcare provider for personalized recommendations.
The length of time to see results means consistency and patience are important.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
What are the recommendations for a pulled muscle injury to fully recover?
Pulled Muscle Recovery Time
A pulled muscle, medically known as a strain, occurs when muscle fibers are stretched too far and sometimes tear. A pulled muscle injury typically starts to heal within days. Mild injuries can heal completely in one to three weeks, but more serious strains or tears, depending on the severity, can take six to 12 weeks or longer. (Fernandes T. L., Pedrinelli A., & Hernandez A. J. 2015) Rest, hydration, healthy foods, and slowly returning to activity can help expedite healing time.
Timeline
The timeline for recovering from a pulled muscle depends on the injury’s severity.
Pulled muscles are typically categorized into three grades based on the degree and size of pulled muscle fibers, as follows (Hospital for Special Surgery, 2024)
Grade 1 (mild)
Heals in a few days.
A microscopic tear or stretch in the muscle fiber.
It might feel sore, but you can still use the muscle.
Grade 2 (moderate)
Heals in four to six weeks.
A partial tear in the muscle causes noticeable pain and swelling, making it harder to move or use the injured muscle.
Grade 3 (severe)
Heals in several months
This type of muscle strain causes a complete tear, also known as a rupture.
It results in intense pain, significant swelling, and inability to use the muscle.
Surgery may be required in some cases.
Larger muscles, such as the hamstrings and quadriceps, may take longer to heal than smaller muscles due to their increased size and greater weight-bearing loads.
Body Parts More Susceptible To Injury
The following are more susceptible to muscle strains, pulls, or tears (Nölle L. V. et al., 2022)
Neck – levator scapulae and trapezius
Shoulders – rotator cuff muscles
Lower back – erector spinae
Groin – adductors
Front of the thigh – quadriceps
Behind the thigh – hamstrings
Calves – gastrocnemius and soleus
Healing Stages and Factors
Pulled muscles heal in three predictable stages, though the timing and progression may vary by individual and injury severity (Baoge L. et al., 2012).
Inflammatory Stage (zero to three days)
When pulling a muscle, the body reacts instantly with an inflammatory response that may include swelling, redness, bruising, and pain.
Rest is important during this stage to prevent the injury from getting worse.
Repair Stage (three to 21 days)
Damaged muscle fibers are repaired and regrow during this stage.
Collagen fills in any tears to rebuild damaged muscle tissue.
Gentle movement and easy activity can help the fibers line up properly and reduce stiffness.
Start slowly moving a pulled muscle as soon as possible, but avoid too much activity too soon, as it can delay and prolong healing.
Remodeling Stage (three weeks to one year)
Repaired tissue gets stronger and adapts to regular movement.
Gradually adding more activity, stretching, and strengthening exercises helps treat a pulled muscle and return to full strength and function but should be done carefully to avoid re-injury.
Avoid activities that cause pain, but move the muscle gently to prevent stiffness.
Prolonged rest can slow healing, so maintain a balance between rest and exercise.
Ice
Add ice for 10–20 minutes for the first 48 hours to reduce swelling and pain.
Ice helps control inflammation by limiting blood flow to the injured area.
Compression
Use compression stockings or wrap the injured part in bandages to help reduce swelling.
Ensure the binding is not too tight so circulation is not cut off.
Elevation
Raise the injured area above heart level throughout the day.
This helps reduce swelling by allowing fluids to drain away from the injury site.
Heat
After the first two to three days, heat therapy increases blood circulation and improves flexibility, helping the muscle heal.
Eat Healthy
Get enough protein for muscle repair.
Maintain Hydration
Drink plenty of water to help with circulation and muscle lubrication.
Massage and Physical Therapy
These hands-on interventions can improve circulation, help reduce scar tissue, and restore range of motion.
Over-the-counter Medications
If needed, over-the-counter nonsteroidal anti-inflammatory medications like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium) can help with pain and swelling.
Only use as directed.
These steps can help promote faster healing and expedite returning to normal daily activities.
When to Resume Normal Activity
Individuals may need one to two weeks to recover before resuming normal activity for mild strains. However, for more severe injuries, it could take four to six weeks or longer to return to all daily activities. (Harvard Health Publishing, 2023) It’s essential to gradually return to daily activities to avoid reinjury, which can delay and prolong healing. Follow these recommendations to recover from a pulled muscle safely and quickly (Kraemer W., Denegar C., & Flanagan S. 2009)
Once the pain has subsided, the swelling has decreased, and the muscle feels better, start with low-impact exercises.
Slowly resume normal activities, avoiding overexerting the injured area.
Gradually increase activity levels and stop if there is any pain.
Avoid strenuous activities that place excessive stress on the injured muscle until the muscle is completely healed.
Contact a Healthcare Provider
While most pulled muscles heal with home care, seek medical attention if: (Penn Medicine, 2023)
Pain persists or worsens after seven to 10 days.
This can indicate a more serious injury, such as a severe torn muscle.
Significant pain, loss of motion and strength, and swelling disrupt daily activities or show signs of worsening despite rest and self-care.
It is difficult to move the affected area, or the muscle cannot bear weight, suggesting a more severe injury.
There are signs of infection, including redness, warmth, increased swelling, or fever, especially if the skin is cut or broken near the injured area.
There is unusual bruising or a visible deformity, which could indicate a bone fracture requiring professional evaluation.
A healthcare provider may recommend imaging studies, such as MRI, ultrasound, or X-rays, to assess the extent of the injury, rule out fractures, or check for muscle tears.
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Say Goodbye to Pain with Chiropractic Care
References
Fernandes, T. L., Pedrinelli, A., & Hernandez, A. J. (2015). MUSCLE INJURY – PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT, AND CLINICAL PRESENTATION. Revista brasileira de ortopedia, 46(3), 247–255. doi.org/10.1016/S2255-4971(15)30190-7
Nölle, L. V., Mishra, A., Martynenko, O. V., & Schmitt, S. (2022). Evaluation of muscle strain injury severity in active human body models. Journal of the mechanical behavior of biomedical materials, 135, 105463. doi.org/10.1016/j.jmbbm.2022.105463
Baoge, L., Van Den Steen, E., Rimbaut, S., Philips, N., Witvrouw, E., Almqvist, K. F., Vanderstraeten, G., & Vanden Bossche, L. C. (2012). Treatment of skeletal muscle injury: a review. ISRN orthopedics, 2012, 689012. doi.org/10.5402/2012/689012
Laumonier, T., & Menetrey, J. (2016). Muscle injuries and strategies for improving their repair. Journal of Experimental Orthopaedics, 3(1), 15. doi.org/10.1186/s40634-016-0051-7
Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: considerations in the transition from medical care to performance care. Sports Health, 1(5), 392–395. doi.org/10.1177/1941738109343156
Broken bones are common injuries. Because children’s bones grow rapidly, they have increased flexibility. When injuries, specifically fractures, occur, they do not always break cleanly across the bone or into pieces. What type of fracture is this, and how are they treated?
Greenstick Fracture
A greenstick fracture is a partial break in a bone that occurs when a bone bends and cracks instead of breaking into separate pieces. (Wolfe J. A. et al., 2019) The term is based on a young green branch that bends and splinters but does not break into pieces when bent. Only one side of the bone is broken, while the other side gets bent. Many children experience at least one fracture during their growing years. This is one of multiple fracture types seen in children. They can happen in adults but are uncommon.
Causes
Greenstick fractures mostly occur in infants or toddlers, sometimes in children during their early adolescent and pre-adolescent years. They are partial-thickness fractures (a break in a bone that doesn’t completely break it) characterized by a break on one side and a bend on the other. Buckle fractures and bow fractures are different types of partial-thickness fractures. Greenstick fractures commonly occur:
In children under 10 years old
Occurs when a child reaches out to break a fall
During motor vehicle collisions
Sports
Direct impacts
Non-accidental trauma
It is more common in long bones, including:
Radius
Ulna
Humerus
Fibula
Tibia
Clavicle
The fracture pattern often indicates a limb’s bending or contortion.
Deformity, such as the affected body part looking crooked or out of alignment.
Treatment
If the bone is not significantly bent out of alignment, a splint or cast may be all that is necessary to treat the break. If the bone is visibly out of alignment, it must be manually straightened before the limb is put into a cast. If the break is severe, surgery may be required. Fortunately, a growing skeleton can remodel bone, so fractured bones can often realign themselves over time with minimal intervention. Healing depends on various factors, including:
Sometimes, the fracture must be bent back and repositioned in a fracture reduction procedure. An anesthetic may be used as the doctor manually realigns the bone into the correct position. After the reduction, a cast or splint will stabilize the bone and maintain proper alignment. Depending on how quickly the bone heals, a cast may be necessary for a few weeks, months, or longer, depending on the patient and/or underlying conditions.
Healing
Healing involves specialized cells that gradually rebuild and fine-tune the new bone.
The average time for a greenstick fracture to heal completely may take four weeks.
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Building a Stronger Body
References
Wolfe, J. A., Wolfe, H., Banaag, A., Tintle, S., & Perez Koehlmoos, T. (2019). Early Pediatric Fractures in a Universally Insured Population within the United States. BMC pediatrics, 19(1), 343. doi.org/10.1186/s12887-019-1725-y
Pountos, I., Clegg, J., & Siddiqui, A. (2010). Diagnosis and treatment of greenstick and torus fractures of the distal radius in children: a prospective randomised single-blind study. Journal of children’s orthopaedics, 4(4), 321–326. doi.org/10.1007/s11832-010-0269-3
Are individuals with high foot arches or participating in sports involving repetitive ankle motion at risk for developing peroneal tendon injuries?
Peroneal Tendon Injuries
The peroneal tendons connect the muscles of the outer side of the lower leg to the foot. They may be acute—occurring suddenly—or chronic—developing over time. The basic types of peroneal tendon injuries are tendonitis, tears, and subluxation.
Anatomy and Function
The two major peroneal muscles (peroneus longus and peroneus brevis) are outside the lower leg, next to the calf muscles. The peroneal tendons run along the outer side of the ankle and attach to the foot, connecting these muscles to bone. They help stabilize the ankle joint, point the foot downward (plantarflexion), and turn the foot outward (eversion). In normal gait, the motion of the peroneal muscles is balanced by the muscles that invert the foot or rock the foot inward from the ankle. The two peroneal tendons sit one on top of the other right behind the fibula (the smaller lower leg bone). This closeness can contribute to problems with the peroneal tendons, as they rub together behind the ankle.
Tendonitis
The most common problem is inflammation or tendonitis. The tendons are usually inflamed just behind the fibula bone at the ankle joint. This part of the fibula is the bump on the outside of the ankle, and the peroneal tendons are located just behind that bony prominence. Tendonitis can either result from repetitive overuse or an acute injury. Common symptoms of tendonitis include:
Pain behind the ankle
Swelling over the peroneal tendons
Tenderness of the tendons
Pain usually worsens if the foot is pulled down and inwards, stretching the peroneal tendons.
Typical treatment of peroneal tendonitis is accomplished by:
Ice application
Applying ice to the area can help reduce swelling and control pain.
Rest
Resting is important to allow the tendon to heal.
A supportive device (walking boot or ankle brace) or crutches can help in severe cases.
Braces and boots provide support, reduce tendons’ stress, and allow rest and inflammation to subside.
Anti-inflammatory Medications
Motrin or Aleve are anti-inflammatory and can reduce the swelling around the tendon.
Physical Therapy
Physical therapy can help restore normal ankle joint mechanics, help with swelling and pain relief, and correct strength imbalances.
Cortisone Injections
Cortisone injections are low-risk if administered to the area around the tendon and not more often than every three months.
Ultrasound guidance can help ensure the medication is injected into the correct area. (Walt J. & Massey P. 2023)
Tendon Tears
Tears can occur and are more likely to happen in the peroneus brevis tendon. Tears are believed to be the result of two issues with the tendon. One is the blood supply. Tears of the peroneus brevis tendon almost always occur in the area where the blood supply and nutrition of the tendon are the poorest.
The second issue is the closeness between the two tendons, causing the peroneus brevis tendon to be wedged between the peroneus longus tendon and the bone. (Saxena A., & Bareither D. 2001) Tears of the peroneus brevis tendon are often treated with the same treatments for tendonitis. About half of the tears diagnosed by imaging are found to be asymptomatic. For individuals who don’t find lasting relief from symptoms, surgery may be necessary. Surgical options for peroneal tendon tears (Dombek M. F. et al., 2001)
Tendon Debridement and Repair
During a tendon debridement, the damaged tendon and the surrounding inflammatory tissue are removed.
The tear can be repaired, and the tendon can be tubularized to restore its normal shape.
Tenodesis
A tenodesis is a procedure where the damaged area of the tendon is sewn to the normal tendon.
In this case, the damaged segment of the peroneal tendon is removed, and the ends left behind are sewn to the adjacent remaining peroneal tendon.
Tenodesis is often recommended for tears involving more than 50% of the tendon. (Castilho R. S. et al., 2024)
Depending on the surgical procedure, Recovery after surgery can take several weeks of restricted weight-bearing and immobilization. Following immobilization, therapy can begin. Recovery is usually six to 12 weeks, depending on the surgery, but a full return to sports and activities may take several months. Risks of surgery include infection, stiffness, skin numbness near the incision, persistent swelling, and persistent pain.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Saxena, A., & Bareither, D. (2001). Magnetic resonance and cadaveric findings of the “watershed band” of the Achilles tendon. The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons, 40(3), 132–136. doi.org/10.1016/s1067-2516(01)80078-8
Dombek, M. F., Orsini, R., Mendicino, R. W., & Saltrick, K. (2001). Peroneus brevis tendon tears. Clinics in podiatric medicine and surgery, 18(3), 409–427.
Castilho, R. S., Magalhães, J. M. B., Veríssimo, B. P. M., Perisano, C., Greco, T., & Zambelli, R. (2024). Minimally Invasive Peroneal Tenodesis Assisted by Peroneal Tendoscopy: Technique and Preliminary Results. Medicina (Kaunas, Lithuania), 60(1), 104. doi.org/10.3390/medicina60010104
Triceps tendonitis can be frustrating, especially when you need to rest from normal activities. Can knowing the causes, symptoms, and diagnosis help individuals understand the treatment and prevention of the condition?
Triceps Tendonitis
Tendons are connective tissue that attach muscles to bones, enabling the joints to move. Triceps tendonitis is inflammation of the tendon at the back of the elbow. It is most often caused by overuse of the triceps muscles. The condition can cause pain, swelling, and loss of function. It’s common in jobs that require regular hammering, shoveling, and overhead reaching, as well as in weightlifters, gymnasts, and boxers.
Causes
The triceps muscle runs along the back of the upper arm and is attached to the point of the elbow by a tendon. This muscle straightens the elbow. Tendonitis develops from repeatedly straightening the elbow against resistance. This causes tiny tears in the tissue, which leads to inflammation. Triceps tendonitis commonly occurs from repetitive manual labor tasks or sports activities like throwing sports, gymnastics, or boxing. Exercises that target the triceps muscle can cause tendonitis to develop, including kickbacks, dips, push-ups, and bench presses. For this reason, triceps tendonitis is also known as weightlifter’s elbow. (Orthopedic & Spine Center, N.D.)
Symptoms
Inflammation leads to a series of chemical reactions in the area of the injury. There are five main symptoms of inflammation:
Redness
Warmth
Swelling
Pain
Loss of function
With triceps tendonitis, the pain and stiffness are felt at the back of the elbow. Weakness may also present when using the affected arm. Tendonitis usually causes more pain with movement than when resting. Pain can occur when straightening the elbow, which puts tension on the triceps, or bending the elbow, which stretches the tendon.
Diagnosis
A healthcare provider will ask questions and perform a physical exam to diagnose tendonitis. (Harvard Health Publishing, 2014) A healthcare provider will ask you to describe the pain and the activities that make it better or worse. The elbow will be assessed for movement issues, swelling, or deformities that could indicate a worse injury, like a tendon tear. A healthcare provider will order X-rays or other imaging, such as MRI, to assess for a bone fracture or more extensive damage to the tendon.
Treatment
Several types of treatments include self-care, physical therapy, and medications.
Self Care
Triceps tendonitis can be treated at home if symptoms are addressed early. These include:
Rest
Rest the triceps tendon by avoiding activities that cause pain for a few days.
Ice
Apply ice to the triceps tendon for 15 to 20 minutes, two to three times daily.
Massage the area with an ice cube for several minutes.
Range of Motion Exercises
Decrease stiffness in the elbow with gentle range of motion exercises.
Slowly bend and straighten the elbow in a pain-free range, 10 times.
Repeat several times per day.
Physical Therapy
Physical therapists use various therapies and tools when treating tendonitis, including (Prall J. & Ross M. 2019)
PT Modalities
Physical therapy modalities are used to decrease pain, inflammation, and stiffness.
Examples include ultrasound, electrical stimulation, and light therapy.
Manual Therapy
Manual techniques for tendonitis include soft tissue massage, friction massage, stretching, and joint mobilization.
Exercise
Stretching and strengthening exercises that target the triceps muscle and any other muscle weakness that might have contributed to the condition.
Activity Modification
A therapist will look at the activities that led to the tendonitis and ensure you use the correct form and proper body mechanics.
Sometimes, a physical therapist can make on-site changes in the work environment to help prevent further injury.
Nonsteroidal anti-inflammatory medications are often used to treat tendonitis.
Many are available over-the-counter, including Aleve, Bayer, and Advil.
These medications can also be prescribed in higher doses by a healthcare provider.
Pain-Relievers
Additional over-the-counter medications such as Tylenol can help decrease pain.
Oral Steroids
These medications might be prescribed for short-term use to decrease inflammation if over-the-counter medications are ineffective in treating symptoms.
Tendonitis is frequently treated with an injection of steroid medication to decrease inflammation.
However, having multiple injections in the same area can eventually cause tendons to weaken more. (NYU Langone Health, 2024)
Platelet-Rich Plasma
PRP is made by taking a small amount of blood and separating the platelets or cells that release growth factors to promote healing.
The liquid is then injected into the tendon.
PRP is controversial; some studies support its use, while others do not.
While PRP may show some promise, insurance may not cover PRP treatments because of the ambiguity in the clinical data.
Injury Medical Chiropractic and Functional Medicine Clinic
Prevention is key. Warming up before a workout, stretching, and using the proper form can help prevent triceps tendonitis. Temporarily halting activities to address symptoms can prevent more serious injury. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Prall, J., & Ross, M. (2019). The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist. Journal of Exercise Rehabilitation, 15(2), 193–199. doi.org/10.12965/jer.1836636.318
Spoendlin, J., Meier, C., Jick, S. S., & Meier, C. R. (2015). Oral and inhaled glucocorticoid use and risk of Achilles or biceps tendon rupture: a population-based case-control study. Annals of Medicine, 47(6), 492–498. doi.org/10.3109/07853890.2015.1074272
Could older individuals who do not have symptoms of shoulder pain or loss of shoulder and arm function have a rotator cuff tear?
Rotator Cuff Tear Physical Therapy
A rotator cuff tear is a common injury to the four muscles and tendons surrounding and stabilizing the shoulder joint. Studies have shown that (Geary M. B., & Elfar J. C. 2015)
30% of those under the age of 70
70% of those over age 80 have a rotator cuff tear.
Physical therapy is often recommended as a first-line initial treatment for rotator cuff pain. In most cases, a rotator cuff tear will not need surgical treatment. Determining when surgery is necessary depends on several factors a patient can discuss with their healthcare provider.
Causes
Overuse and repetitive motions
Trauma (e.g., falls, collisions)
Age-related degeneration
Symptoms
Shoulder pain, especially with overhead or rotational movements
Weakness and difficulty raising the arm
Clicking or grinding sounds in the shoulder
Limited range of motion
Treatment
The goal of physical therapy for a rotator cuff tear is not necessarily to heal the torn tendon but to relieve pain and improve strength by reducing inflammation and restoring shoulder joint mechanics. This is achieved through physical therapy, ice application, anti-inflammatory treatments like medications, and cortisone injections.
Physical Therapy
The goal of physical therapy is to improve the function of the muscles that surround the shoulder. Physical therapy targets the smaller muscles around the shoulder that are commonly neglected. By strengthening these muscles, the treatment can help compensate for damaged tendons and improve the mechanics of the shoulder joint. A chiropractic physical therapy team will develop a personalized exercise program. Generally, rehabilitation will start with gentle range of motion exercises that can be accomplished using the arms to lift a mobility stick/wand overhead.
Shoulder Pulleys
These improve shoulder range of motion and flexibility.
Isometric Exercises
These exercises are for the rotator cuff muscles and may then be started.
This exercise can improve the contracting of the muscles around the shoulder and offer more support to the shoulder joint.
Scapular Stabilization Exercises
These can also be done to improve the muscles surrounding the shoulder blade’s function.
This can help improve how the shoulder joint, arm, and scapulae move together when using the arm.
Advanced Strengthening
Advanced exercises can be done with a dumbbell or resistance band.
Consult your healthcare provider or physical therapist before starting these or any other exercises for a rotator cuff tear. Doing exercises correctly prevents further pain, injury, or shoulder problems. Specific, focused exercises can help expedite and regain normal shoulder function.
Injury Medical Chiropractic and Functional Medicine Clinic
The prognosis for rotator cuff tears depends on the severity of the tear and the individual’s overall health. With proper treatment, most people can regain the full function of their shoulders. However, some may experience ongoing pain or limitations in severe cases. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Shoulder Pain Chiropractic Treatment
References
Geary, M. B., & Elfar, J. C. (2015). Rotator Cuff Tears in the Elderly Patients. Geriatric orthopaedic surgery & rehabilitation, 6(3), 220–224. doi.org/10.1177/2151458515583895
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