Evidence-Based Treatment Options for Tendonitis in Anchorage, AK: Where to Go and What Works

Introduction 

Tendonitis, also known as tendinopathy, is a fairly common condition that causes pain and impaired function in the tendons it affects (e.g. Achilles, patellar, rotator cuff, etc…). Many people in the Anchorage, AK area suffer from tendonitis, but there are ways to treat it.

Of course, the particular treatment used will vary depending on the tendon affected and severity of the injury.

We’ve constructed this guide to detail some of the treatment options available for tendonitis and where you can find such treatments in Anchorage. 

I. Conservative & Rehabilitation-Based Treatments

A. Eccentric Exercise Programs

Eccentric exercise (e.g. negative reps) are a type of exercise that focuses on the phase of muscle movement in which the muscle is lengthening instead of contracting. It has application as a type of conservative and rehabilitation-based treatment for tendonitis.

Eccentric exercise is best used for tendonitis in the Achilles, the patellar, the gluteal, and the rotator cuff. It involves guided tendon loading routines performed slowly under tension.

A study on NIH found that “When treating tendinopathy regardless of location, eccentric exercises were the best treatment option to improve tendinopathy-related pain and improve self-reported function.“¹

Healthcare offices and professionals that provide eccentric exercise treatments include: physical therapy clinics and sports medicine physiotherapists. In the Anchorage area, these can be found at:

• Orcaak
• Alaska Fracture and Orthopedic Clinic
• Better Health Alaska

B. Therapeutic Modalities: ESWT & LLLT

Another type of treatment modality is Extracorporeal Shockwave Therapy (ESWT). This non-invasive treatment utilizes soundwaves to stimulate healing in the body. It is best for chronic upper-limb tendonitis (e.g. tennis elbow, rotator cuff). 

A study in Frontiers in Medicine found that “ESWT can effectively improve the functional activity in patients with rotator cuff tendonitis and may produce positive analgesic effects in patients with upper limb tendonitis. The incidence of adverse effects is low.”²

It is available at the following locations:

• Runner’s Edge Alaska
• Community Chiropractic

Low-level Laser Therapy (LLLT) is another technology-based treatment modality. It is best used on lower extremity tendonitis. It can be found at these locations in Anchorage:

• Pairmore and Young: Synergy Chiropractic
• Lucas Chiropractic and Enlighten Functional Health

You will typically find these treatment modalities in physical therapy centers, and in sports rehab clinics that are equipped with the appropriate tech. Places in Anchorage that offer such include: 

C. Chiropractic Care

Chiropractic care is another treatment method available to patients suffering from tendonitis. It is particularly useful in cases related to joint misalignment or poor biomechanics (e.g. rotator cuff, Achilles, elbow, etc…).

The techniques used will usually be joint mobilizations, soft tissue therapy (e.g. Graston Technique, and Active Release Technique), and/or therapeutic exercise. 

The best places to go for chiropractic care for tendonitis are chiropractors trained in sports medicine or certified in soft-tissue mobilization techniques. 

• Better Health Alaska

II. Pharmacologic and Injection-Based Interventions

A. Local Corticosteroid Injections

One type of pharmacological injection-based intervention is a local corticosteroid injection at the site of the injured tendon. This is best used for short term relief in cases like lateral epicondylitis, and the rotator cuff. 

It is effective over the short term, but less so for extended periods according to a study on pubmed by the NIH.³  

Individuals can find corticosteroid injections at the following locations:

• Alaska Center for Pain Relief Inc.
• Neuroversion
• Advanced Pain Centers of Alaska

B. Ultrasound-Guided Corticosteroid + Exercise

Another injection-based treatment to be considered is an ultrasound-guided corticosteroid that is used in conjunction with exercise. It is best used for cases of Achilles tendonitis.

You can access such treatment at an interventional sports medicine clinic or a PM&R clinic. Here, in Anchorage, examples of such include:

• Algone Anchorage Interventional Pain Clinic
• Schumacher Orthopedics

C. Platelet-Rich Plasma (PRP) Injections

Another injection-based therapy is platelet-rich plasma (PRP) injections. This involves injecting platelets directly into the site desired to speed healing. It is best used for rotator cuff tendonitis, but may still be used in other tendonitis cases.

A study on the Journal of Orthopaedic Surgery & Research found it to be as effective as corticosteroids in most cases of tendonitis with the exception of the rotator cuff where it demonstrated increased improvement in pain and range of motion.⁴

Individuals seeking PRP Injections can usually find them at regenerative medicine clinics or sports medicine centers that offer them. Here is a short list of such locations:

• Better Health Alaska
• Arctic Medical Center
• Orcaak
• Algone Anchorage Interventional Pain Clinic

III. Needling and Advanced Techniques

A. Dry Needling (Tendon Needling)

Dry needling is a treatment in which thin needles are inserted into the trigger points in the muscle. This causes the muscle and tendon to relax, thereby eliminating the pain. It is best used for chronic tendonitis that is not responding to other treatments.

A study on Taylor and Francis online found “evidence suggests that tendon needling improves patient-reported outcome measures in patients with tendinopathy.”⁵

Patients seeking dry needling should visit a physical therapy office or a sports rehab clinic certified in dry needling. In Anchorage, examples of such include: 

• Alaska Physical Therapy Specialists
• Empower Physical Therapy
• Reger Physical Therapy

IV. Surgical & Minimally Invasive Options

A. Minimally Invasive Procedures (Tenotomy, Microtenotomy)

The last type of treatment to discuss are surgical procedures: tenotomy and microtenotomy. These are similar surgeries that involve cutting a tendon to cause its release. The difference is that microtenotomy uses smaller incisions and some special instruments.

These options are usually used in cases that do not respond well to conservative care that has been administered for at least six months. A study on PubMed found that minimally invasive surgeries were more effective than open surgery.⁶  

These procedures are typically performed at orthopedic surgical centers and specialized sports surgery units. In Anchorage, AK these include:

• Alaska Orthopedic Specialists
• Orthopedic Physicians Alaska
• Alpine Surgery Center

V. Where to Seek Care for Tendonitis

The following chart lists the type of providers required for each particular type of treatment.

Conclusion

According to the evidence discussed above, eccentric exercise stands out as the most effective treatment for tendonitis and the one to be turned to first. Other therapies like ESWT, LLLT, and targeted injections serve as useful adjuncts that provide added benefits – particularly in persistent cases. Surgery and/or minimally invasive procedures should be reserved for cases resisting conservative care.

Whether you live in Anchorage, AK or elsewhere, the first step, of course, is seeing a medical professional such as a chiropractor, a physical therapist, a certified professional in sports medicine, or an orthopedic surgeon.

Here at Better Health Alaska, we offer chiropractic care, physical therapy, and massage therapy all under one roof. We have been dealing with tendonitis for over 25 years and a wealth of knowledge at our disposal. So, reach out and schedule an appointment. We’ll get you in and seen and on your way to recovery.

1. Irby, A., et al. “Clinical management of tendinopathy: A systematic review of systematic reviews evaluating the effectiveness of tendinopathy treatments,” PubMed, 2020 Oct;30(10):1810-1826. https://pubmed.ncbi.nlm.nih.gov/32484976/ 
2. Xiong, Y., et al. “Efficacy and safety of extracorporeal shock wave therapy for upper limb tendonitis: a systematic review and meta-analysis of randomized controlled trials,” Frontiers in Medicine, Front. Med., 29 July 2024 https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1394268/
3. Irby, A., et al. “Clinical management of tendinopathy” PubMed, 2020. https://pubmed.ncbi.nlm.nih.gov/32484976/ 
4. Dadgostar, H., et al., “Corticosteroids or platelet-rich plasma injections for rotator cuff tendinopathy: a randomized clinical trial study,” Journal of Orthopaedic Surgery and Research, Published: 21 May 2021, Article number: 333 https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02470-x
5. David, K., et al., “Tendon needling for treatment of tendinopathy: A systematic review,” The Physician and Sports Medicine, 2015, Vol. 43, Iss. 1, https://www.tandfonline.com/doi/full/10.1080/00913847.2015.1004296