Tendonitis

What is Tendonitis?

The tendon is the end part of a muscle that attaches the muscle to the bone. The normally very elastic and soft muscle tapers off at the end to form the much denser and stiff tendon. While this density makes the tendons stronger, the lack of elasticity of the tendon and the constant pulling on its attachment to the bone with movement, makes it much more susceptible to a low level of tearing at a microscopic level. This tearing will produce the inflammation and irritation known as tendonitis.

Tendonitis is usually seen after excessive repetitive movement when the tendon gradually becomes tighter until the fibres start to tear. For example, a person who plays tennis may over-use the muscles of the elbow through hitting the ball repetitively and cause tendonitis to the area.

The most common tendon areas that become inflamed are the elbow, wrist, biceps, shoulder (including rotator cuff attachments), leg, knee (patella), ankle, hip, and Achilles. Of course, tendonitis will vary with each person, as it strikes the areas you use most.

Symptoms of Tendonitis:

Symptoms can vary from an aching pain and stiffness to the local area of the tendon, to a burning that surrounds the whole joint around the inflamed tendon.

Causes of Tendonitis:

With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiffer the following day.

Relief and Prevention of Tendonitis:

With proper care for the area, the pain in the tendon should lessen over three weeks, but it should be noted that the healing of the area continues and doesn't even peak until at least six weeks following the initial injury. This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together. Scar tissue will continue to form past six weeks in some cases and as long as a year in severe cases. After 6 months this condition is considered chronic and much more difficult to treat. The initial approach to treating tendonitis is to support and protect the tendons by bracing any areas of the tendon that are being pulled on during use. It is important to loosen up the tendon, lessen the pain, and minimize any inflammation.

This can be done if a pain reliever has the ability to penetrate the skin barrier and contains anti-inflammatory agents. A topical formula that contains natural menthol will not only relieve pain, but dilate the blood vessels. This allows for relief of the tendonitis, without causing any stiffening of the tissue.
Ice can relieve inflammation, but will constrict the blood vessels and further stiffen the tendon. Cortisone injections can reduce inflammation, but unfortunately are very caustic and can cause a weakening of the tendon structure and create more scar tissue.
After the scar tissue has begun to accumulate, it will be important to perform procedures which help break down the scar tissue in the tendon tissue, to let the tendon and muscle regain it's normal flexibility and lessen the chance of further injury. While exercise is appropriate for breaking down scar tissue once the area has healed, it may further irritate the area during the initial stages.
Therefore, other methods that can be performed by your healthcare provider, such as ultrasound and massage, may be safely used to accomplish this early on in the injury. Ultrasound uses sound waves that vibrate at such a fast level, it cannot be felt with normal use. Ultrasound will cause an increase in circulation to the tissue and soften the scar tissue to allow it to further break down.

Tendonitis Prevention

Prevention of this condition requires stretching the muscle on a regular basis and thereby lengthening the tendon connection. This will allow less pulling on the tendon attachment to the bone. When tendonitis does occur, it is important to treat it immediately, and thereby prevent it from reaching a stage that is more severe.