No longer chronic?

Photo by Beth Wilson

Thanks to Inés for sending in this article and the following translation (do not reproduce without her permission). I admit this confuses me…I thought tendinitis was always chronic.

“Nadal has no longer a chronic injury” by Juan José Mateo as translated by Inés

The doctors of the tennis player, who reappears in Toronto, “optimistic” after his knee treatment

Those were two quick trips that can change a career. “We are optimistic,” explain medical sources, familiar with the two visits that Rafael Nadal made this summer to the clinic La Esperanza in Vitoria, where the player treated his battered knees, taking advantage of the month’s scheduled break between his victory at Wimbledon and the Toronto tournament, which starts today. “The progress has been good: from diagnosis of chronic tendinopathy, with which he came, it has turns out that the tendinitis he had, is not chronic. In medicine it is impossible to ensure that something is healed forever, but the prevision, however, it’s that with this he is fine and there should not be a need for re-treatment. ”

These are injections of autologous plasma, rich in growth factors that are introduced directly into the damaged tendons. This is what Nadal has suffered – “A brave,” describe medical sources, so painful is the treatment – to overcome the sharp pains he felt in the quadriceps tendon of his left knee and the patellar tendon in his right knee. And this, two express trips to Vitoria, round trip in one day to see doctor Mikel Sanchez, with only having time to eat on one occasion. As tight was the doctor’s agenda, so swift were the patient’s trips – is what is in the mind of the champion when he comes to Toronto, (as) he begins to prepare his first tournament after the magical Roland Garros – Wimbledon double and he talks.

“I feel good,” said the number one, who will play the doubles with Serbian Novak Djokovic, the second best player of the planet, and that he will be looking for the U.S. Open, from August 30, the only major title missing. “I have confidence in my tennis,” Nadal said before his single’s debut in Canada, probably on Wednesday, to which he comes “a bit tight (of shape) “, because he has only been training three weeks: “Now I am thinking about my tennis, not my body. I’m in perfect condition. ”

“The left knee has progressed very well,” hospital sources confirmed, who know firsthand the joints of the player, still yet fearful, like everyone, of a treacherous slip. “The pain has really gone down. We stopped the treatment because of the positive progress” they said. “The real test is the American tour because it is on concrete, the more aggressive surface. On grass and clay, the knees have responded well. Now he will come for medical revision, which is to get resonance and ultrasound, but the prevision is that with this, he will be fine”.

The real test is the cement, aggressive file that punishes the joints while it corrodes the shoes. The real test is the U.S. Open. And the real test is to lead in a turbulent time in tennis, that Nadal has as the only secure value.

When 2010 started, Nadal was a cornered tennis player. He had played the Australian Open, he had retired with an injured right knee and he had accumulated 11 months without winning a title. At the turn of 8 months, the scenario is radically different. Nadal is the number one. Nadal has split a whole month between two trips to Vitoria, several days of rest in Ibiza, Menorca and Majorca and a mini preseason in Manacor. Nadal has done all that, his relatives dismayed by the pain suffered during the treatment, susceptible to the cancellation of any arranged tournament, with only one goal: on the horizon appears New York, the dream of the U.S. Open and the consolidation of his influence in the Olympus of tennis. The Toronto tournament starts, and Nadal plays it thinking in the only Grand missing in his list of winners

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17 Responses

  1. Kate says:

    If it is an inflammation it can be cured. However like all it could flare up again but hey if he takes care of “the knees” he should be OK….this is why I don’t play on hard courts tho

  2. tiemyshoe says:

    As I understand it, tendonitis isn’t always chronic – it can be acute inflammation, too. (I think there’s a type of chronic tendonitis that goes beyond inflammation and affects collagen production or something… I may be making this up though. Too lazy to google!) But for athletes, I imagine it’s as good as a chronic condition when 1) they keep doing the activity that causes the inflammation, with insufficient rest, and 2) they don’t have any treatment for the inflammation besides rest.

    I’m not sure this is a miracle cure for Rafa, but if it can fall somewhere between “temporary patchup” and “miracle,” then it’s got to be a positive thing. Rafa’s got youth on his side, which must be a plus. Blake got the same type of treatment last year and it didn’t really solve his problems, it seems – but he’s a lot older.

    *fingers crossed* for Rafa. Hopefully the pain was worth it.

    • GB says:

      Definitely joining in the finger crossing!

      I don’t know if Blake’s that much older in tennis terms, given what a prodigy Rafa was: quickly looking at the ATP site, seems Rafa’s actually played 10 more tour matches than Blake (544 to 534). Everyone’s case is obviously unique though, and I think Blake’s wasn’t helped by his unwillingness to take pain medication.

      Ultimately, I guess it’s a case of waiting to see how the knees hold up in this h/court stretch.

    • natch says:

      “I imagine it’s as good as a chronic condition when 1) they keep doing the activity that causes the inflammation, with insufficient rest, and 2) they don’t have any treatment for the inflammation besides rest.”

      Not just athletes. Once you get any type of injury, inflammation, tendonitis…whatever, you are susceptible to it again. Therefore, tendonitis is always chronic. You may go for periods with it in a dormant stage, but it will reflare. How often depends on genetics, body type, nutrition, hydration…and many other factors, including luck and use of injured area.

      I didn’t have time to read the entire article, but this part:

      A brave,” describe medical sources, so painful is the treatment –

      cracked me up. I haven’t had the treatment in my knee, but I have had it in my shoulder. It’s bothersome, but not “so painful”. That kind of gave me an indication of how much knowledge the author has of the procedure – very limited. My boys who have had their knees done tell me it’s not that bad, either.

      “I’m not sure this is a miracle cure for Rafa, but if it can fall somewhere between “temporary patchup” and “miracle,” then it’s got to be a positive thing.”

      There you go, tie. It’s a common procedure, and probably the best for his injuries. (Well, besides greater flexibility, but that’s a whole other topic.) As an athlete, you can’t ask for more.

      • miri says:

        cracked me up. I haven’t had the treatment in my knee, but I have had it in my shoulder. It’s bothersome, but not “so painful”. That kind of gave me an indication of how much knowledge the author has of the procedure – very limited. My boys who have had their knees done tell me it’s not that bad, either.

        And judging from how active Rafa was the day it was done (visiting local sports teams, flying around the world), it sounds like he’d agree. There was a report that he asked if there was a way to avoid stairs, so some pain and swelling, but not horrid if he was up and around that much.

        • Inés says:

          Rafa himself said in one Wimbledon press conference in Spanish, that the treatment was very painful and because of that he needed time for this, it’s specially painful because the injections are introduced directly into the damaged tendons. And in one of the last interview, when he started to practice again, has said again that it was painful. Don’t forget that Rafa has a pain threshold very high and he can resist pain without a blink, so if he says that is painful, it must be very painful

          • natch says:

            I’m afraid I’ll have to agree to disagree with Rafa. My injections were introduced directly into my injury, too. Without any anesthetic. No problemo. :)

          • CC says:

            So maybe Rafa’s pain threshold isn’t that high after all…? Or maybe he just wanted some compassion from people around him. Men are like that sometimes, no? :)

      • tiemyshoe says:

        If the procedure is so common, I wonder why he didn’t do it earlier. Strange. Hasn’t platelet therapy been around for a long time?

        • miri says:

          I’m not 100% sure, but it might have to do with WADA. The procedure isn’t even approved for all conditions. A female player got in trouble for using it on her back last year.

        • natch says:

          I don’t know how long it’s been around, either. But it has exploded in popularity as treatment. That’s why it is more common and accepted now. Miri’s right about approval. Under some circumstances it’s still considered experimental.

          Btw, it didn’t work on me. :( But my injury was pretty substantial…and I’m old ;), so I wasn’t holding out a lot of hope.

  3. Silhouette says:

    AS long as Rafa thinks he’s in perfect condition, I’m happy! He’s come a long way to be able to listen to his body. It would be great joy to have many more years of Rafa tennis :-)

  4. Rafangel says:

    Please, God.

    Thank you Ines, you are a wonderful wonderful person to translate such a long article, and to translate so often. We are hugely indebted (and super-impressed).

  5. Fay says:

    Oh I hope so Rafa! *fingers crossed too*. and thankyou thankyou Ines for the translation you are a credit to this site!

  6. robert says:

    Generally speaking, tendinopathy refers to a disease of a tendon. More specifically, it can refer either to tendonitis (informally also tendinitis, meaning acute inflammation of a tendon due to overuse) or to tendinosis (sometimes called chronic tendinits, which is damage to a tendon at cellular level).

    Obviously, tendinosis is worse. There’s no inflammation but there are micro tears inside a tendon.

    Judging by the article, Rafa originally had damaged tendons and now they have been healed. Ergo, no longer chronic. Plasma injections are only used to help the regeneration of those micro tears, not to cure tendonitis, which is cured with antiinflammatories, icing and rest.

    • robert says:

      It goes without saying: untreated tendonitis leads to tendinosis, or actute inflammation turns into chronic micro damage of a tendon, and that is what happened to Rafa.

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