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Question:

What is the difference between tendonitis and tendinopathy and how can they be treated?

Answer:

Tendons attach muscle to bone and help the joints to move fluidly. They are made of different types of collagen. When injured, tendons have difficulty healing because they are poorly vascularized. The tendon will attempt to heal itself by laying down collagen that is not as strong as the original tendon fibers, which can create thickening and pain over time.

An injury to tendons can take up to 10 weeks to heal. In these initial weeks of healing, patients are diagnosed with tendonitis. If pain persists longer than 10 weeks, or the tendon appears thickened on imaging (such as MRI), patients are diagnosed with tendinosis or tendinopathy. Tendinopathy is a mix of tendinitis and tendinosis. Tendinosis typically refers to tendons that have chronic inflammation resulting in tendon thickening.

It Hurts! Now What?

There are many treatment options available. Initially, self-care should focus on icing the area, gentle massage and/or stretching, anti-inflammatories and rest.

A physician may recommend conservative treatment options such as physical therapy or cortisone injections into the tendon to reduce pain. We caution our patients against repeated cortisone injections though, because they may weaken the tendon over time. There is some evidence that supports eccentric-based exercises — stretching a muscle while it is under a load. A biceps curl with a dumbbell is an example. This type of exercise remodels the tendon and can lessen pain. More advanced tendinopathy may be treated surgically, but this is rare and may result in only some improvement.

Another treatment option is platelet-rich plasma and stem cell injections for tendon injuries. This is a procedure in which your own blood platelets or adult stem cells are injected into the injured area.

Warm weather means outdoor pastimes for many of us. If you like to read, this time of year means you’re heading to a porch or patio with a good book. Lorain Public Library System’s director of marketing Jennifer Black put out a call to their book club members for a few of their favorites. Enjoy!

The NINTH HOUR

By Alice McDermott

Dark and intense, The Ninth Hour begins with a suicide in 1920s Catholic Brooklyn. This sad incident begins a chain of events that ultimately deal with the meaning of grief and dignity, love and loss, as well as the meaning of faith. With dense, well-realized characters, this novel is not to be missed.

BITTER ORANGE

By Claire Fuller

Bitter Orange is a seductive novel that explores desperation and longing. With deft psychological portraiture, the novel recalls the fractured, damaged summer that one woman experienced in the English countryside in 1969. With evocative writing and a haunting plot-line, Bitter Orange is a perfect read for those who like their novels in the vein of Daphne du Maurier’s Rebecca.

HARRY TRUMAN’S EXCELLENT ADVENTURE

By Matthew Algeo

When Harry Truman left the White House in January 1953, he picked up a new Chrysler New Yorker and enjoyed a 2,500-mile road trip from his Missouri home to the East Coast and back. It was the last time a U.S. president or ex-president traveled without the Secret Service, and Truman’s hopes to travel privately unraveled almost immediately. The book offers a delightful glimpse into a vanished America, before interstate highways and chain restaurants.

LILAC GIRLS

By Martha Hall Kelly

World War II unfolds very differently for three women in this touching and inspiring tale of three women in the United States and Europe. An American socialite in New York City, a Polish teenager who is captured while working for The Resistance, and a German doctor who is assigned to a concentration camp all cross paths in unexpected ways as they are forced to deal with wartime conditions beyond their control.

Music can call at any age. These NEO musicians started playing when the muse was ready; some early, some later.

CHAD PENGAL

Chad Pengal, 61, has been interested in bluegrass music since he was in seventh grade, but he didn’t get serious about playing it until his mid-50s.

“I always wanted to learn,” says the homebuilder and owner of Chadwick Homes in Mentor. To that end, 15 years ago, he bought a banjo and started experimenting. “I started plucking away but didn’t get anywhere. I wasn’t able to concentrate until my kids grew up and moved out. I was involved with them and their activities. Once my kids grew up, I found I had a lot more spare time to work on learning to play the instruments.”

In his 50s, he started taking lessons on a five-string banjo and was soon jamming with local musicians at one of their homes. That led to a band that played small, local venues for a year before members went their separate ways.

When Pengal met his now-girlfriend, Gloria Severino, he took his playing to a new level. Severino had recently left a popular Northeast Ohio club band after a 23-year career as a singer and musician. She saw talent in Pengal’s playing and talked him into starting a duo.

Today that duo – Pickin Rocks – plays bluegrass, country and Americana songs at bars, restaurants and wineries in Northeast Ohio. Pengal plays banjo and standup bass, while Severino plays acoustic guitar. Both do power vocals.

“I’ve always loved music,” says Pengal. “I like live music and going to small places and seeing talented musicians. All my family is musical. My dad plays button box with the Fairport Harbor Jammers. My sister has a band that plays around town. And my son is a full-time, professional musician in Nashville.”