Tendonitis

A tendon is a tough yet flexible band of fibrous tissue. The tendon is the structure in your body that connects your muscles to the bones.

Tendons come in many shapes and sizes. Some are very small, like the ones that cause movements of your fingers, and some are much larger, such as your Achilles tendon in your heel. When functioning normally, these tendons glide easily and smoothly as the muscle contracts.

What is tendonitis?
Sometimes the tendons become inflamed for a variety of reasons, and the action of pulling the muscle becomes irritating. If the normal smooth gliding motion of your tendon is impaired, the tendon will become inflamed and movement will become painful. This is called tendonitis, and literally means inflammation of the tendon.

What causes tendonitis?

• Overuse. Commonly, individuals begin an exercise program, or increase their level of exercise, and begin to experience symptoms of tendonitis. The tendon is unaccustomed to the new level of demand, and this overuse will cause an inflammation and tendonitis.
• Age-related changes of the tendon. As people age, the tendons loose their elasticity and ability to glide as smoothly as they used to. With increasing age, individuals are more prone to developing symptoms of tendonitis.
• Anatomical cause for tendonitis, such as arthritis. If the tendon does not have a smooth path to glide along, it will be more likely to become irritated and inflamed. In these unusual situations, surgical treatment may be necessary to realign the tendon.

Are X-rays or MRIs needed to diagnose tendonitis?
X-rays and MRIs are not usually needed to make the diagnosis of tendonitis but they may be performed to ensure there is no other problem, such as a fracture, that could be causing the symptoms of pain and swelling.

Symptoms of Tendonitis
Symptoms can vary and depends on the tendon that is affected, the cause and how severe the inflammation is. Symptoms may include:

• Pain that gets worse if you try to move the affected area.
• A sensation that the tendon is grating or a crackling sensation when it moves – this can often be felt on examination.
• Swelling, heat or redness around the area.
• Weakness in the affected area.
• Slight bruising.

Common types of tendonitis

• Achilles tendonitis – pain is just above the back of the heel.
• Elbow tendonitis – Lateral epicondylitis, also called ‘tennis elbow’, causes pain on the outer side of the forearm near the elbow. Medial epicondylitis, also known as ‘golfer’s elbow’, results in pain on the inner side of the forearm near the elbow.
• Patellar tendonitis – pain is just below the knee.
• Rotator cuff tendonitis – pain is near the shoulder.

Complications
Tendonitis if untreated may become chronic or long term and can lead to the rupture of the tendon.

Tendonitis treatment:
To treat tendonitis at home, P.R.I.C.E. is the acronym to remember — protection, rest, ice, compression and elevation.

• Protection – Immobilise the affected area to encourage healing and to protect it from further injury. You may need to use elastic wraps, slings, splints, crutches or canes.
• Rest – Avoid activities that increase the pain or swelling. Don’t try to work or play through the pain. Rest is essential to tissue healing. But it doesn’t mean complete bed rest. You can do other activities and exercises that don’t stress the injured tendon. Swimming and water exercise may well be tolerated. Although rest is a key part of treating tendonitis, prolonged inactivity can cause stiffness in your joints. After a few days of completely resting the injured area, gently move it through its full range of motion to maintain joint flexibility.
• Ice – Apply ice for up to 10 minutes as soon after the injury as possible – do not wait for the swelling to start. This may be repeated every 2 hours during the first 72 hours after injury.
• Compression – Because swelling can result in loss of motion in an injured joint, compress the area until the swelling has ceased. Wraps or compressive elastic bandages are best.
• Elevation – If tendonitis affects your knee, raise the affected leg above the level of your heart to reduce swelling.

Our Approach
Our treatment involves increasing the blood circulation to the tissues. This can be done by alternating hot and cold hydrotherapy, massage, dry needling and the use of ultrasound. When the pain has subsided our rehabilitation trainer will work with you to create a programme of strengthening and stretching exercises for the affected muscles, taking care that the exercises are done slowly and carefully so as not to make the condition reoccur.

The information provided is for general guidance only and must not be used for diagnosis or treatment of a health problem. This information is not intended to be a substitute for professional medical advice.