Billy Gilhooley's Guide to Tendon Relief: The Effectiveness of Joint Manipulation

I'm Billy Gilhooley, director of Specific Physiotherapy Preston. If you've ever dealt with nagging tendon pain, like that Achilles heel that's been bugging you during runs or the elbow that's acting up after too much tennis, then you know how frustrating tendinopathies can be. As a physio, I see this stuff every day in my clinic.

People come in with sore tendons, we prescribe some solid rehab exercises to strengthen things up, but sometimes the joint right below or near that tendon stays stubbornly stiff. That's when a little "crack" (you know, that satisfying pop from a joint manipulation) can make all the difference. Let me break it down for you in plain English, like we're chatting over a coffee.

Expert tendon relief by Billy Gilhooley Physiotherapist: Witness a precise joint adjustment easing knee pain with skilled care

What's Going On with Your Tendon?

First off, tendinopathy is basically your tendon's way of saying, "Hey, I'm overworked and irritated!" It happens when tendons (those tough cords connecting muscles to bones) get overloaded from repetitive activities, like gym workouts, sports, or even daily walking.

Symptoms? Pain, stiffness, and that annoying ache that won't quit. We often start treatment with exercises to build strength and resilience in the tendon, think eccentric heel drops for Achilles issues or controlled wrist extensions for elbow tendinopathy.

But here's the kicker: if the joint immediately deep to the tendon (like the ankle joint under your Achilles or the elbow joint near your tennis elbow) is stiff, those exercises might not hit the spot fully. Why? Because a stiff joint forces the surrounding tissues, like your muscles, ligaments, and especially that tendon to pick up the slack and load more than they should. It's like driving a car with a seized wheel; everything else has to work overtime, leading to more wear and tear.

In my experience, this is super common. A patient might come in saying their rehab isn't cutting it, and sure enough, that joint feels locked up. Studies back this up too—joint stiffness can alter how loads are distributed, putting extra stress on the tendon. For a deeper dive, check out this paper on manual therapy's role in treating tendinopathy.

The Magic of the "Crack"

So, what do I do? I give that joint immediately deep to the tendon a mobilisation or manipulation - often called cavitation, which creates that audible pop from gas bubbles releasing in the joint fluid. The joint moves better, and suddenly, the pain eases up. For some folks, it's instant relief right there on the table.

For others, it kicks in over a day or two as things settle. Why does this work? Well, when the joint's stiff, it's not gliding smoothly, so the tendon has to compensate by taking on more force.

Once we "crack" it, the joint regains some mobility, distributing loads more evenly. That means less overload on the tendon, and poof - pain drops.

It's not voodoo; it's biomechanics and a bit of neurophysiology at play, where the manipulation calms down pain signals and relaxes tight muscles around the area.

I've seen this with all sorts of tendinopathies. Take subacromial pain syndrome (that shoulder pain from rotator cuff issues) - a manipulation of the glenohumeral joint can work wonders by improving shoulder mobility and offloading the tendon. Or lateral knee pain, often linked to iliotibial band issues - a tweak to the proximal fibula head can ease the strain on the surrounding tissues.

For Achilles tendinopathy, a quick ankle joint adjustment does the trick. If you're dealing with supraspinatus tendinopathy (a common shoulder tendon issue), head over to this helpful article from Specific Physiotherapy for more tips.

But What If the Pain Comes Back?

Ah, the million-dollar question. That relief? It's awesome, but it might only last a week or so if the stiffness sneaks back. No worries - we crack that same joint again for quick relief, but I'm not just about short-term fixes.

The real game-changer is figuring out why the joint's getting stiff in the first place and nipping it in the bud. Often, it's down to everyday habits or form issues that overload the joint and, by extension, the tendon.

For instance:

• Gym mishaps: I see heaps of people doing overhead shoulder presses with poor form, which overloads the shoulder joint and irritates the rotator cuff tendons. Or push-ups with elbows flaring out like chicken wings—that's a recipe for elbow joint stiffness and tennis elbow tendinopathy.

• Walking woes: Bad gait can stiffen up the ankle or knee joints, leading to Achilles or patellar tendinopathy. Sometimes, it's as simple as needing new insoles to tweak your foot alignment.

• Other culprits: Lunges with wonky knee tracking? That can overload the joint deep to the tendon, causing downstream tendon grief.

In the clinic, we'll get you moving with our exercise equipment to spot these issues. I'll watch you do a set of presses or lunges and say, "Aha! Let's adjust that elbow tuck." Fixing the form prevents the stiffness from returning, which means the tendon doesn't get hammered repeatedly. Over time, as we reduce that overload, the tendon's reactivity (that inflamed, painful state) calms down, and healing kicks in for good.

Want to see how we assess this? Book a session or learn more about ankle treatments from the pros at Specific Physiotherapy's ankle pain guide, which covers Achilles tendinopathy spot-on.

Billy Gilhooley's Message: Prevention Is Key

At the end of the day, tendinopathies don't have to rule your life. A stiff joint immediately deep to the tendon might be the hidden villain overloading it, but with a targeted manipulation for relief and smart tweaks to your movements, we can keep things moving smoothly.

If you're tired of that cycle of pain, pop into the clinic - we'll sort the quick fix and the long-term plan.

Questions? Drop me a line through our contact page.

Stay strong and mobile,

Billy Gilhooley

Physio & Tendon Whisperer