The skeletal muscles in your body are responsible for moving your bones, thus enabling you to walk, jump, lift, and move in many ways. When a muscle contracts it pulls on a bone to cause movements. The structure that transmits the force of the muscle contraction to the bone is called a tendon. A tendon is a tough yet flexible band of fibrous tissue. It 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.
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.
The most common cause of tendonitis is 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. Another common cause of symptoms of tendonitis is due to 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. The cause of these age-related changes is not entirely understood, but may be due to changes in the blood vessels that supply nutrition to the tendons. Sometimes there is an anatomical cause for tendonitis. 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.
Tendonitis is almost always diagnosed on physical examination. Findings consistent with tendonitis include:
- Tenderness directly over the tendon
- Pain with movement of muscles and tendons
- Swelling of the tendon
Studies such as x-rays and MRIs are not usually needed to make the diagnosis of tendonitis. While they are not needed for diagnosis of tendonitis, x-rays may be performed to ensure there is no other problem, such as a fracture or bone spurs, that could be causing the symptoms of pain and swelling. X-rays may show evidence of swelling around the tendon. MRIs are usually only performed if there is a suspicion of another problem, such as degeneration of tendon.
Tendonitis treatment must begin by avoiding aggravating movements. This may mean taking a break from a favorite activity for a period of time, but this is a necessary step to allow the inflamed tendon to heal. It is also recommended in tendonitis treatment to try alternative activities; for example, if you are a runner who is experiencing knee pain due to tendonitis, try incorporating swimming into your workout schedule. The proceeding information may also help:
Apply an Ice Pack
Icing the area of inflammation is an important aspect of tendonitis treatment. The ice will help to control the inflammation and decrease swelling.
Take Anti-Inflammatory Medications or Gels
Tendonitis treatment can be improved by these medications (Ibuprofen, Motrin, Naprosyn, Celebrex, etc., or topical anti-inflammatory gels or creams such as Voltaren Gel) that will decrease pain and swelling. Be sure to talk to your doctor before starting these medications.
Cortisone Injections
If the symptoms of tendonitis are persistent, an injection of cortisone may be considered. Cortisone is a powerful anti-inflammatory medication, but instead of being given by mouth, it is injected directly to the site of inflammation. This can be extremely helpful for situations that are not improved with rest. Not all types of tendonitis can be addressed with cortisone injections.
Strengthening and Physical Therapy
Proper strengthening technique can help treat and avoid tendonitis by using your muscles in a safe, more efficient manner.
In some chronic cases of tendonitis, when other treatments fail, such as rest, anti- inflammatory medications, therapy and change of activities, then a potential biologic solution treatment is available. Refer to the PRP injection education for additional information.
