Do tendons cause rebound tenderness?

From the Guidelines

Sinew can cause rebound due to its elastic properties, which are crucial for efficient movement and energy storage in tendons like the Achilles tendon. When considering the context of overuse tendon problems, it's essential to understand that most patients seen in primary care will have chronic symptoms suggesting a degenerative condition, such as tendinosus or tendinopathy, rather than an acute inflammatory condition 1. The natural history of these conditions involves gradually increasing load-related localized pain coinciding with increased activity.

In the context of sinew rebound, the elastic properties of tendons allow them to store and release energy, which is vital for efficient locomotion. This rebound mechanism is particularly important in major tendons of the legs, where it can return up to 70% of the energy that would otherwise be lost. The examination of patients with overuse tendinopathies should include thorough inspection, range-of-motion testing, palpation for tenderness, and examination maneuvers that simulate tendon loading and reproduce pain 1.

Key points to consider when evaluating sinew rebound include:

• The elastic properties of tendons, which allow for energy storage and release
• The importance of sinew rebound in efficient locomotion, particularly in the Achilles tendon and other major tendons of the legs
• The need for accurate diagnosis and treatment of overuse tendinopathies, which can involve relative rest, icing, and eccentric strengthening exercises 1
• The potential use of treatments like ultrasonography, shock wave therapy, orthotics, massage, and technique modification, although few data exist to support their use at this time 1.

From the Research

Sinew Cause Rebound

• The relationship between sinew cause rebound and non-steroidal anti-inflammatory drugs (NSAIDs) is not directly addressed in the provided studies 2, 3, 4, 5, 6.
• However, the studies discuss the effects of NSAIDs on soft-tissue injuries, tendon healing, and bone healing.
• According to 2, NSAIDs have a mild effect on relieving symptoms and are potentially deleterious to tissue healing.
• Study 3 summarizes the mechanisms by which bone, tendon, and enthesis healing occurs, and describes the effects of NSAID therapy on each of these processes.
• The study 4 found that short-term ibuprofen treatment has no effect on gene expression in human chronic tendinopathic tendon or leads to any clear changes in tendon pain or function.
• The review 5 compared NSAIDs with other oral analgesics for treating acute soft tissue injuries and found that NSAIDs make no difference to pain at one to two hours and at two to three days, and may make no difference at day seven or beyond.
• Study 6 investigated the effect of NSAIDs on tendon-to-bone healing following acute injury or surgery and found that the current literature does not provide sufficient evidence for or against the use of NSAIDs following acute injury or surgical repair of the tendon-bone interface.