From the Guidelines
Heat and stretching are crucial for tendinitis before activity as they prepare the affected tendon for movement, reducing the risk of further injury and improving flexibility. Applying heat for 15-20 minutes before exercise, as suggested by general principles of physiology, increases blood flow to the area, warming the tendon and surrounding tissues, making them more pliable and less likely to tear during activity 1. Following heat application, gentle stretching of the affected tendon is recommended. The most recent and highest quality study on flexibility exercise, published in 2018, recommends holding a static stretch for 10–30 s, with a series of flexibility exercises for each of the major muscle–tendon units, and performing 60 s of total stretching time for each flexibility exercise, repeated two to four times 1. Key points to consider when implementing heat and stretching for tendinitis include:
- Applying heat using a warm towel, heating pad, or warm shower
- Gentle stretching to avoid aggressive movements that could worsen the condition
- Gradually warming up the activity itself rather than jumping immediately into intense exercise
- Avoiding complete immobilization to prevent muscular atrophy and deconditioning, as rest alone may not promote tendon healing 1. Overall, the combination of heat and stretching reduces stiffness and pain during subsequent activity by making tendons more elastic and helping to realign collagen fibers, thus improving the tendon's functional capacity.
From the Research
Importance of Heat and Stretching for Tendinitis
- Heat therapy is used to increase blood flow, metabolism, and elasticity of connective tissues, which can help reduce pain and promote healing in tendinitis 2.
- Stretching, particularly flexibility exercises, can be beneficial for tendinitis, especially in the upper limb 3.
- Combining heat therapy with stretching and other exercise interventions, such as strengthening exercises, may be more effective than using heat therapy alone 3.
Benefits of Heat Therapy for Tendinitis
- Heat therapy can provide short-term reductions in pain and disability 2.
- Heat therapy can increase the elasticity of connective tissues, which can help reduce muscle spasm and promote healing 2.
Benefits of Stretching for Tendinitis
- Stretching can help improve flexibility and range of motion, which can reduce the risk of further injury 3.
- Stretching can help reduce muscle spasm and promote relaxation, which can help reduce pain and promote healing 3.
Combining Heat and Stretching with Other Exercise Interventions
- Combining heat therapy with stretching and other exercise interventions, such as strengthening exercises, may be more effective than using heat therapy alone 3.
- Exercise therapy, including heat therapy, stretching, and strengthening exercises, can be safe and beneficial for tendinitis, and can help improve function and reduce pain 3.