Tendinitis

Tendinitis is inflammation of a tendon. A tendon is a strong fibrous piece of tissue that connects muscle to bone. There is a tendon at the end of each muscle connecting it to a bone. Tendons have a very thin, smooth sheath covering them called the peritendon. When the peritendon is inflamed it is called peritendinitis. Most tendinitis is mild inflammation of the tendon. When the inflammation is severe, there may be deterioration of the fibers within the tendon. This causes pain and makes it difficult to play sports or be active. Severe, long-term Tendinitis may weaken or even rupture the tendon.

Causes

Tendinitis is caused by overuse of a muscle-tendon unit. With overuse there is repeated strain on the tendon. Eventually the tendon cannot withstand the strain and it begins to get very tiny tears.
Overuse can be the result of doing any activity too much, such as:
  • Playing a sport
  • Physical labor
  • House work
Tendinitis can develop in almost any tendon of the body. However, the following tendons are more commonly involved than the others:
  • Achilles
  • Rotator cuff in the shoulder
  • Biceps in the shoulder
  • Wrist extensors near the elbow – on the outside
  • Wrist flexors near the elbow – on the inside
  • Patellar tendon – attached to the kneecap

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Muscle imbalance
  • Decreased flexibility
  • Overweight
  • Advancing age
  • Sex: Female
  • Alignment abnormalities of the leg

Symptoms

Symptoms include:
  • Pain, particularly with activity
  • Local swelling
  • Decreased motion of adjacent joints

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. In particular, the doctor will as about your physical activity and the location of the pain. Tests may include: X-rays – to look for calcium deposits in the tendon, a sure sign of tendinitis, though not present in most cases MRI scan – to confirm the diagnosis and show the amount of damage to the tendon (more likely when symptoms continue despite treatment)

Treatment

Treatment depends on:
  • Severity of symptoms
  • The tendon involved
  • Length of time symptoms have lasted
Treatment may include:
  • Rest for the affected tendon
  • Anti-inflammatory medications
  • Ice after activity
  • Warm the affected area before activity
  • Cast or splint for immobilization of the affected area
  • Cortisone injection into the sheath of the tendon
  • Counterforce brace over the painful tendon
  • Shoe orthotics for foot alignment problems
  • Gentle stretching of the tendon
  • Strengthening of the involved muscle
  • Surgery

Prevention

To prevent Tendinitis:
  • Gradually work yourself into shape for a new activity.
  • When increasing the length of time and intensity of activities, do so gradually.
  • If you have a tendon that has been a problem, gradually stretch out that tendon.
  • Strengthen the muscle attached to the tendon.
  • If you have pain do not ignore it. Early treatment can prevent the problem from becoming serious.
  • Learn to back off from activities if you are tired or not used to the activity.