Tendons are structures that join muscles to bones. Tendinitis/tendonitis refers to an inflamed tendon. When there is an injury to any structure in the body, an inflammatory process is begun in order to heal the body. This process usually lasts only a few days. Tendons can certainly be inflamed - tendinitis exists - but it is rare that a patient seeks medical care during this short time frame. What is more common is that a patient will seek care later on, when the pain has been around for a bit longer.  A tendon problem (in the elbow, shoulder, knee, etc.) that is not acutely inflamed is generally referred to as a tendinopathy. 

Tendinopathy broadly means there is a problem with the tendon. As a tendon is part of a muscle, its job is to provide strength. I examine a tendon, therefore, by stressing the tendon's ability to provide strength, or resist force. Additionally, a pathological tendon will usually hurt when it is being stretched, so I can stretch it to see the patient's response.  When I listen to a patient's history, I am looking for a report of consistent pain each and every time the tendon is used. If the patient says some days it hurts when I lift my arm forwards and other days it doesn't, for example, the tendon (or muscle, for that matter) is not at fault. A pathological tendon will not feel fine sometimes when it is used and hurt other times - it will consistently hurt when stressed.  When I hear reports of variability of symptoms, I begin to think of joint problems, not tendon or muscle problems. In that case, I will examine the tendon, but will also look closely at joint mechanics. In my clinical experience, tendinopathy is commonly misdiagnosed; more often a joint is at fault. 

Another wonderful demonstration of how so many problems in our bodies originate from nerve impingement at the spine - and how a McKenzie clinical evaluation can discern this! In this scenario the patient's complaints of ear fullness, hearing impairment, and sinus congestion (right-sided) are successfully treated with moving the neck backwards (a motion called retraction). The nerves that exit from the upper neck interact with the cranial nerves which supply the ear. By moving the neck in this one specific direction the nerves coming from the upper neck are decompressed, leading to  symptom relief. The video is 24 minutes. Enjoy! -- Laura