For some aches and pains, rest and ice may be all you need. This method may help some forms of overtraining where your body just needs a break. With rest, your muscles actually get stronger after training which causes microtrauma and subsequent pain. However, with some forms of overuse, you may develop what is called a tendinopathy. This just means your muscle group is not able to keep up with the stress demands. Many times, this is happening secondary to weakened surrounding structures. Too much of your workload is being picked up by one muscle group instead of an ideal situation where there are many muscle groups involved. This is a general pattern that leads to a tendinopathy.

With tendinopathies, fibrosis (very small areas of scar tissue) can develop within the tendon and the muscle belly from overuse. Tendinopathies are associated with fibrosis development, which is not a swelling condition. This is different from tendonitis where there is inflammation and swelling. Hence, rest and ice may help a tendinitis but after time, it will not help a more progressive tendinopathy.

The video below demonstrates an old Eastern Medicine technique known as Gua Sha. In the physical therapy world, it is commonly referred to as “instrument-assisted massage.” Recent research has shown that this can help break up some of the fibrosis and decrease pain with a few physical therapy treatments. Following treatment, exercises to correct your movement pattern to decrease the stress on the area and make the area stronger will prevent future injuries.

This demonstration shows treatment to the back side of the forearm where a tendinopathy, commonly known as tennis elbow can develop. Additionally, this treatment can be very effective for many types of injuries not limited to plantar fascitis (fasciosis), heel pain, shin splints, ITband syndrome, and runner’s knee (patella-femoral pain syndrome).