Tendinitis
Tendinitis is a condition in which the tendons, the tough bands of fibrous connective tissue that connect muscles to bones, become irritated or inflamed. Often nicknamed after the sports known to increase patients’ risk (tennis elbow, pitcher’s shoulder and jumper’s knee, for example), this condition typically results from repetitive overuse or sudden overloading of the tendon(s) and supporting muscles. It can cause pain, tenderness and swelling around the affected joint. Tendinitis can usually be treated without surgery.
Types
- Achilles tendinitis is characterized by inflammation of the Achilles tendon (the tendon that connects the calf muscles to the heel bone).
- Elbow tendinitis is characterized by inflammation of the tendons on either the outside of the elbow (known as “tennis elbow”) or the inside of the elbow (known as “golfer’s elbow”).
- Knee tendinitis is often referred to as “jumper’s knee” and is characterized by inflammation of the patellar tendon (the tendon that connects the kneecap to the shin bone) or the quadriceps tendon (the tendon that connects the kneecap to the quadriceps muscles).
- Shoulder tendinitis is sometimes referred to as “pitcher’s shoulder” or “swimmer’s shoulder” and is characterized by inflammation of the tendons that connect the upper arm bone to the shoulder blade.
Symptoms
- Pain
- Swelling
- Tenderness
Prevention
- Avoid or modify physical activities that involve repetitive overuse of the tendon(s) and supporting muscles.
- Perform exercises that strengthen the muscles used frequently during regular activities.
- Cross-train by supplementing athletic training with lower-impact exercises, such as swimming or biking.
- Stretch after participating in physical activities.
- Watch your technique. Performing certain exercises incorrectly can place more pressure on the tendon(s) and supporting muscles.
Risk factors
- Older age
- Participation in sports and other physical activities (including occupational activities) that involve repetitive overuse of the tendon(s) and supporting muscles
Diagnosis
- Review of medical records and physical exam. Providers will discuss patients’ symptoms and medical history and examine the affected area for signs of swelling, redness, tenderness, weakness and a reduced range of motion.
- Blood tests. Blood tests may be recommended if the inflammation is thought to result from an inflammatory disease, such as rheumatoid arthritis or gout.
- Imaging. X-rays may be used to ensure that the pain is not the result of a dislocation or fracture. MRI and ultrasounds may also be used to determine the extent of the damage to the tendon(s).
Treatment
- Medications and injections, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and/or steroidal injections, can help reduce pain and swelling.
- Physical and/or occupational therapy can help patients regain strength, function and range of motion and often includes more specialized treatments, such as deep heat or water therapy.
- RICE (rest, ice, compression and elevation) can help patients prevent reinjury, reduce swelling and relieve pain.
- Temporary use of a brace, sling or splint can help protect patients from reinjury by limiting range of motion.
- Surgery is rarely recommended for tendinitis but may be advised if the injury is extensive or fails to respond to more conservative treatments.
Follow-up care
- If surgery is required, patients may be placed in an immobilization device, such as a cast, splint or walking boot, and will require rehabilitation.
- Follow the surgeon’s recommendations for returning to activity.