The right treatment depends on why you're sore

Small changes can ease mild soreness

Complete rest usually isn't needed for a mild ache. Use the painful movement less often for several days. Easy bending can keep a stiff joint loose, and cold may soothe it after a busy day.

A brace can steady an ankle or limit a painful wrist movement. Ask which movement the brace is meant to stop. Medicine may not fit your health or other drugs. Your doctor can help you make that choice.

The tendon is a tough cord that links a muscle and bone. When it's sore, slow and steady strength work may help. Add an exercise set or a little weight only if you aren't worse later. Rest alone won't prepare that cord for harder use.

The exam shows which care fits the ache

What happens during a sports medicine visit? You'll explain where it hurts and when the soreness began. The clinician may look for swelling, test how it moves and check your strength. Those checks help narrow down what is causing the ache.

Ask when booking who will do the exam. It may be a doctor, nurse or another trained clinician. Describe your recent activity, old injuries, weakness and pain at night. Also explain which home care helped, even for a short time.

Some signs need care that same day. Sudden weakness, joint heat or numbness can't be brushed off. You may also be unable to put weight on it after a fall. Those problems need a medical check right away.

If soreness stays, QC Kinetix offers blood-based options

QC Kinetix provides regenerative treatments, its term for non-surgical care using material from your body. Its medical providers are trained clinic workers who examine you and give the care. Ask whether yours will be a doctor, nurse or another trained clinician. No treatment works the same way for everyone.

PRP is short for platelet-rich plasma, a treatment made from your blood. The clinic draws some blood and spins it so the platelets gather together. Those tiny blood parts help stop bleeding. The prepared blood then goes into your sore area as a shot.

Concentrated PRP puts a larger platelet amount into the prepared blood. That larger amount doesn't promise more relief. Your exam and health history help decide whether either choice fits. Ask why one is being offered and what it may cost.

Some people consider these treatments instead of knee or hip surgery. Strength work and a slow return to activity can still matter. The clinician checks how you move, where it swells and what care you've tried. You'll then hear whether this treatment or different medical care makes more sense.

Sources

1. Tendinopathy is described in the Nature Reviews Disease Primers review as a complex, multifaceted tendon pathology - disorganised collagen fibres, increased microvasculature and sensory nerve ingrowth, dysregulated matrix homeostasis, increased immune cells and inflammatory mediators, and enhanced cell apoptosis - most commonly affecting the rotator cuff, the medial and lateral elbow epicondyles, the patellar tendon, the gluteal tendons and the Achilles. The authors state plainly that management consists of exercise and loading programmes, therapeutic modalities and surgery, and that their effectiveness 'remains ambiguous'.

   Millar NL, et al. — Tendinopathy.. Nat Rev Dis Primers, 2021. DOI: 10.1038/s41572-020-00234-1.

2. Across 41 randomised trials and 2,672 participants, corticosteroid injection reduced tendinopathy pain in the SHORT term but the effect reversed later. For lateral epicondylalgia, corticosteroid had a large short-term effect versus no intervention (SMD 1.44, 95% CI 1.17-1.71), but no intervention was FAVOURED at intermediate term (SMD -0.40, -0.67 to -0.14) and long term (-0.31, -0.61 to -0.01). Of 991 participants injected with corticosteroid in trials reporting adverse events, one (0.1%) had a tendon rupture. Platelet-rich plasma was not more efficacious than placebo for Achilles tendinopathy in the trials available at that time.

   Coombes BK, et al. — Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials.. Lancet, 2010. DOI: 10.1016/S0140-6736(10)61160-9.

3. The Bern consensus frames return to sport as a CONTINUUM that runs in parallel with rehabilitation rather than a single decision at the end of it, and explicitly as an exercise in risk management. It recommends shared decision-making between clinician, athlete and coach, points to biopsychosocial models for individual factors, and to the Strategic Assessment of Risk and Risk Tolerance framework for synthesising the decision. It also states that research evidence to support return-to-sport decisions in clinical practice is scarce.

   Ardern CL, et al. — 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern.. Br J Sports Med, 2016. DOI: 10.1136/bjsports-2016-096278.

4. The American Medical Society for Sports Medicine's position statement on regenerative medicine exists precisely because the field has 'produced widely varying opinions' and because regulators, clinicians, scientists, patient advocacy organisations and the media have raised concern about how these products are used. It sets out terminology, the basic science and clinical evidence for orthobiologics, regulatory considerations, and best practices for introducing them responsibly - describing the evidence as growing that CERTAIN products are safe and potentially efficacious, not as settled.

   Finnoff JT, et al. — American Medical Society for Sports Medicine Position Statement: Principles for the Responsible Use of Regenerative Medicine in Sports Medicine.. Clin J Sport Med, 2021. DOI: 10.1097/JSM.0000000000000973.

5. FDA states verbatim that stem cells, stromal vascular fraction, umbilical cord blood, Wharton's jelly, amniotic fluid and exosome products have not been approved 'for the treatment of any orthopedic condition, such as osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain, or shoulder pain.' Tendonitis and tennis elbow are named explicitly. No exosome product holds FDA approval at all, and the only stem cell products with FDA approval in the United States are blood-forming cells derived from umbilical cord blood, cleared only for disorders of blood production. FDA also states it has received reports of blindness, tumour formation and infections following treatment with unapproved products.

   U.S. Food and Drug Administration — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. FDA (Center for Biologics Evaluation and Research), 2020.

6. Twenty-one patients with chronic lateral epicondylosis were randomised to standard physiotherapy alone or standard physiotherapy plus an isolated eccentric wrist extensor exercise done with an inexpensive rubber bar. Every outcome favoured the eccentric group: DASH improved 76% versus 13%, pain 81% versus 22%, tenderness 71% versus 5%, and strength 79% versus 15%.

   Tyler TF, et al. — Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: a prospective randomized trial.. J Shoulder Elbow Surg, 2010. DOI: 10.1016/j.jse.2010.04.041.

7. A narrative review of dry needling for tendinopathy identified 3 systematic reviews, 7 randomised trials and 6 cohort studies covering the common extensor origin, patellar tendon, rotator cuff and the tendons around the greater trochanter. Most reported statistically significant improvement in patient-reported symptoms, but the needling techniques were highly heterogeneous and the studies were inconsistent about what therapy followed the procedure. The authors describe the evidence as INITIAL SUPPORT and call for trials with proper sham comparators.

   Stoychev V, et al. — Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review.. Curr Rev Musculoskelet Med, 2020. DOI: 10.1007/s12178-020-09608-0.