The tendons are thick, fibrous cords that attach muscles to bones and they can become inflamed and cause pain similar to that experienced by muscle injury and inflammation. This is them referred to as tendinitis and the causes of this condition may be due to:
- Sudden injury sustained to the affected limb or joint.
- Repetitive movements over a period of time that results in increased stress being placed on the affected tendons.
- Occupations that involve the individual being placed into awkward positions to perform duties in, frequent overhead reaching, forceful exertion, and being exposed to repetitive vibrations.
- Using improper techniques to perform certain jobs or sport-related movements.
Types of tendinitis
Some common names of tendonitis pathologies include:
- Golfer’s elbow – involvement of the medial (inside) tendon of the elbow.
- Tennis elbow – involvement of the lateral (outside) tendon of the elbow.
- Swimmer’s shoulder – impingement of the rotator cuff tendon between the acromion of the shoulder blade and the greater tuberosity of the humerus (bone of the upper arm). This is seen in swimmers who specialize in freestyle and front crawling swimming strokes.
- Pitcher’s shoulder – inflammation of the long head of the biceps muscle that attaches to the shoulder which is called bicep tendonitis and may occur in baseball and softball pitchers. This condition may also occur in swimmers where the bicep muscle is involved as well as in any other sports where throwing activities are performed such as javelin and cricket, and where contact occurs such as in wrestling, gridiron football, and martial arts.
- Jumper’s knee – inflammation of the tendon of the patella (knee-cap) or even the quadriceps tendons caused by repetitive straining from too much running and/or jumping.
Signs and symptoms
Patients may present with the following clinical signs and symptoms when dealing with tendinitis:
- Pain that is often described as a dull pain that is felt over the affected area.
- Increased pain when moving the affected limb or joint.
- Tenderness and swelling over the affected area.
- Decreased range of motion of the affected limb which is restricted due to pain.
Tendonitis is managed conservatively with the following therapies:
- Resting the affected limb and not performing movements that cause pain.
- Using pain medication such as acetaminophen and anti-inflammatory medications such as ibuprofen or naproxen.
- Applying ice packs or cold compresses over the affected areas to help reduce swelling and inflammation.
- Physical therapy to help incorporate exercises and to learn correct techniques that will help prevent inflammation of the tendons.
- Steroid and local anesthetic medications can be injected into an affected joint or around an involved tendon to also help reduce inflammation and pain.
- Regenerative medicine in the form of platelet-rich plasma (PRP) can be administered where the platelet cells help to repair damage to a tendon caused by chronic inflammation.
If these therapies are ineffective, then surgical intervention may be warranted. Procedures may include:
- Focused aspiration of scar tissue (FAST) which is performed to remove scar tissue on tendons caused by chronic inflammation of the tissue.
- Arthroscopic tendon repair using small instruments if the inflamed tendon has torn or ruptured.