It’s TendonOSIS Even Though Spellcheck is Being a Jerk About It

“So, even though I’m not getting an MRI I’m still curious about what’s wrong with me. The doctor said it was either a tear or tendonosis. What do you think, based on what you’ve seen with me so far?” I asked Cody*, my physical therapist, during Tuesday’s session.

A little backstory: I had turned down my orthopedic doctor’s suggestion from two weeks prior to get an MRI of my right leg.  It seemed unnecessary since my pain in both the front of my hip and top of my hamstring had lessened quite a bit thanks to therapy, and the thought of being shoved into a tin can coffin for forty five minutes was a big NOOOOPE. I’m not anywhere even remotely close to needing surgery, so all we’d get out of an MRI was a confirmation that my leg’s f-ed up. Yeah, I know already.

The only solution the doctor had offered was a shot of lidocaine into the front of my hip or hamstring, whichever hurt more. What good would a temporary numbing agent do for true healing? The impingement on the front of the hip was barely noticeable anymore and was something I could live with, and I’d already seen vast improvement with my hamstring with only eight weeks of therapy. Besides, the last time I had a needle shoved into my ass was a vaccination as a kid, and I wasn’t exactly looking for new opportunities. No thanks.

I brought up the subject to Cody while I was lying on my stomach on a padded black table in a small exam room and resting the side of my face on my hands. Cody had just started a deep tissue massage of the back of my leg in response to the sharp pain I’d felt the night before in taekwondo class when doing a flying snap kick with the right leg.

When executing a flying kick the TKD student takes a running start, jumps into the air, and pops the leg into a kick. It’s our one little moment of feeling like we’re in The Matrix. I felt a sudden burst of pain when I jumped and shot my foot into the air, and my leg remained irritated for the rest of the night. I hadn’t felt that type of pain in several weeks.

I was very disappointed that I was still having intense pain, but I reminded myself that we weren’t really warmed up for highly aerobic and explosive movement. We had spent most of Monday night’s class doing forms, which is a workout on its own but very low key compared to repetitive kicking and jumping. Even though I’ll only have to do flying snap kick on the right side once during my black belt test on Saturday I wanted to figure out what I could do to minimize pain that might linger during the rest of the test after the long kicking portion was finished. Cody and I were on a mission.

“Well, I’m not sure it matters at this point since you’re not getting an MRI, and the treatment would be the same…a rose by any other name, you know…hmm…” Cody’s hands lingered in one spot for a moment while he thought of what to say.

“Based on where you’re feeling the pain, it presents itself as more of tendonosis. ‘Osis’ means a degenerative state, in this case of the…” He waited a beat for me to answer.

“Tendon!” I replied, playing along with the anatomy lesson.

“Yes, and we’re doing exactly what we should do for tendonosis: repetition, strengthening, and damage control. Tendon-itis, which is inflammation of the tendon, is usually treated with the RICE method: rest, ice, compression, and elevate. If it were really a tear you’d feel it more in the belly of the muscle.” Cody dug his sharp elbow into the meaty middle of my hamstring as if to illustrate his point.

“How long do you think it will take to heal?” I shifted my hands out from under my head and rested my cheek against the pillow. Cody paused from stabbing me with the point of his elbow for a moment and considered my question.

“Six to ten months, maybe a year,” he murmured as he began making deep circles in my thigh with his fingers. “High hamstring tendonosis can be the kiss of death for a sprinter. They injure themselves when they’re pushing really hard towards the end of the season, or in your case, for a black belt test, and if they don’t treat it properly there’s a chance they’ll re-injure themselves during the next season. The tendon likes consistency, so we want to continue doing repetitive exercises. It will also get cranky if you completely stop what you’re doing with it, so you have to keep doing at least some kind of activity. What we’re doing and what you’ll need to continue doing on your own will minimize the risk of re-injury.”

“So…is he comparing me to a sprinter?” I thought as he continued massaging the back of my leg. “I guess I kind of am given the short bursts of speed and power I have to exhibit for sparring and the more demanding jump kicks…Cool.” 

“How does that feel?” Cody asked as he shook the back my leg a few more times and gave my ankles a reassuring pat.

“Good and painful at the same time if that makes sense.” I grimaced as I groggily sat up on the table. Cody smirked and ushered me out of the exam room so I could do my usual exercise routine on my own: side leg lifts while lying on a table, one-legged dead lifts while holding a kettle bell, and stepping up on a box with one leg while raising a kettlebell and lifting my opposite knee.

I took a break from the routine to try a little experiment Cody suggested for dealing with front snap kick, the current bane of my existence. I positioned myself in fighting stance, fists raised and all, and did a short series of front snap kicks with the right foot: ten to the ankle, ten to the torso, and ten to the face. I had to clamp my mouth shut so I wouldn’t ki-hap on instinct and startle all the other patients in the clinic. I felt a sharp burst of pain when I did the first few low kicks, but the leg seemed to relax once I’d warmed it up. By the time I got to the face kicks I could do them without the ripping sensation I’d felt the night before.

I excitedly ran back to the office and told Cody what I’d discovered. We both determined while I wouldn’t be magically healed by the weekend, it was likely by the time I reached the flying kicks portion of the test I’d be fully warmed up, and I shouldn’t feel the amount of pain I’d experienced the night before. Hooray!

So perhaps the saga of my messed up hip and hamstring is coming to a close (for now). We’ll continue therapy until the end of the year, and then I will fly from the physical therapy nest. I have enough exercises in my arsenal to address the problem on my own should it flair up in the future. Or I can call Cody again; I won’t let just anyone poke around my ischial tuberosity.

Now I can focus on other things athletes above a certain age have to worry about: not throwing my back out or getting the flu before the test on Saturday.

And then I can have cake.

*Name changed