This document describes tendon release therapy. It explains that tendons are innervated by the autonomic nervous system and respond similarly to smooth muscles. When a tendon is hypertonic, it becomes rigid. The treatment involves applying pressure to the tendon for 1 minute to release the hypertonicity. Steps for performing tendon release on the Achilles tendon are provided as an example. Indications for tendon release therapy include tendonitis, hypertonicity, and tears/ruptures. Common tendons and disorders that respond well to the therapy are also listed.

1. Tendon Release therapy
Dr Ayesha Anwer Ali

2. Tendon Release therapy
• Tendons are apparently
innervated by the
autonomic nervous
system ,because
functionally they
responds in a similar
manner to smooth
muscles.

3. • when there is the hypertonicity of the tendon, it
presents as a rigidity of the tendon.
• There is reduced capacity of elongation and
contraction of the tendon fibers.
• Treatment of tendons with advance strain and
counterstrain is 1 minute because all innervated
muscles requires 1 minute for the release of
hypertonicity, as compare to 90 seconds release for
voluntary nervous system innervated muscles.

5. Step-by-step instructions for tendon
release therapy:.
1. Place the index finger (or the index finger plus the middle finger) pad
of the distal phalanx of the caudal hand over the place of insertion of
the inferior end of the tendon
2. Place the index finger (or the index finger plus the middle finger) pad
of the distal phalanx of the superior hand over the musculotendinous
interface of the muscle and tendon, at the superior aspect of the
tendon.
3. Push on the tendon tissue with both hands with 1lb force
perpendicular onto the bone.
4. Then compress the superior and inferior aspects of the tendon
together with 1lb force, bringing the distal and proximal end of the
tendon closer together. this compression should be along the
longitudinal length of the tendon fiber
5. Maintain these compressive forces for 1 minute for the release of the
hyper tonicity of the tendon.
6. NOTE:- there may remain fascial restrictions of the tendon, which may
still require fascial release.

6. Example of tendon release: ACHILLES
TENDON:-

7. • Tender point:-
At the insertion of Achilles tendon
• Position of the patient:-
PRONE LYING. A small towel is placed
under the ankle, or foot is off the edge of the
bed/couch, so that the foot and ankle is not
placed in forced planter flexion

10. Treatment :-
1. Place the index finger (or the index finger plus the middle
finger) pad of the distal phalanx of the caudal hand over the
place of insertion of the Achilles tendon at the calcaneus
2. Place the index finger (or the index finger plus the middle
finger) pad of the distal phalanx of the superior hand over
the musculotendinous interface of the gastronemius muscle
with the achilles tendon, at the superior aspect of the
tendon.
3. Push the tissue with 1lb force perpendicular towards the
tibia
4. Then compress the superior and inferior aspect of the
tendon together with 1lb force, bringing the 2 ends of the
tendon closer together.
5. Maintain these compressive forces for 1 minute.

11. Indications of tendon release therapy:-
• There are essentially no contraindication of the tendon
release therapy, when performed in this manner , unless
there is total rupture of the tendon.
• When there is total rupture of the tendon , the technique will
not be effective.
• If there is a tear or rupture of the tendon, but there is a
correction performed (surgical) the technique can be
performed. Although not 100% effective, the technique will
give some results in decreased hypertonicity or rigidity of the
tendon,
• If tendon release therapy is performed immediately after
surgery , there will be facilitated healing of the tendinous
injury

12. Tendons which responds well to tendon
release therapy:-
• Achilles tendon
• Medial and lateral hamstring tendons
• Quadriceps tendon
• Tibialis anterior and posterior tendons
• Extensors/flexors tendons of foot and toes.
• Adductor tendon of hip
• Rotator cuff tendons: supraspinatus, infraspinatus,
subscapularis.
• Flexors/extensors tendons of Wrist and fingers
• Latissimus dorsi
• Biceps (short and long head)
• Triceps tendon
• Coracobrachialis and Brachioradialis tendons….etc

13. Common disorders which responds well
to tendon release therapy:-
• Tendonitis
• Hypertonicity
• Protective muscle spasm and spasticity
• Fibromyalgias
• Tenosinovitis
• Tear and rupture
• Calcification of tendon