This is the latest installment in my series of articles about why structural conditions return after a visit to the chiropractor, physio, massage therapist, etc. Please see here for the previous article.
A tendinous micro-avulsion can be a very difficult condition to identify and resolve. Avulsion is defined in the conventional sense as a tendon (or ligament) that has torn away from the bone. A micro-avulsion is a tearing away from the bone of only a few fibers of the many that exist within the tendon. These fibers recoil and are not able to to reach the bone in order to heal. Most often little to no pain is felt. As with all injuries, the central nervous system now down-regulates neural drive and the muscle belly contracts; this however increases the tension on the injured tendon fibers, pulling it further from the bone.
In most cases a pro-active patient will begin to stretch, again increasing tension on the injured tendon, causing further irritation and damage. Athletes will notice a simultaneous drop in performance and may continue to train the area harder to make up for insufficiency, again worsening the condition. Exercise of any kind will not help!
Micro-avulsion will result in instability/mis-alignment of the corresponding joint, and muscles adjacent to the injured site will inevitably begin to contract as well to contribute stability. This complicates the picture for any practitioner attempting to find the root cause. And so, if any incorrect intervention takes place, symptoms will return.
Proper diagnosis and treatment of this condition is difficult and is unlikely to occur without specific advanced training. If you believe this blog post applies to you and you are in the Vancouver BC area, I recommend making an appointment at my office. Otherwise I can suggest finding a chiropractor in your area who is sufficiently trained in applied kinesiology to find full resolution of your symptoms.