What is Tendonitis?

Tendons are a thick, fibrous band of tissue that connect muscles to bone. Anywhere in the body that there is a muscle, is also a tendon that attaches it to a bone allowing movement of the bone when the muscle is contracted. Tendonitis is an inflammation of this band of tissue, the tendon.

What Causes Tendonitis?

Tendonitis is almost always an injury caused by overuse. Any tendon in the body is susceptible to Tendonitis, but there are areas where the condition is more common. The most commonly affected areas when Tendonitis is the diagnosis are the knees, which include the tendons attaching to the patella, the kneecap. This type of Tendonitis is sometimes referred to as Jumper’s Knee.

Also, common sites of Tendonitis are the lower leg, particularly the ankle as in Achilles Tendonitis and the foundational muscles of the shoulders, the rotator cuff. It is easy to see why the tendons at these joints would be most commonly affected by Tendonitis as they are used the most not only in everyday activity, but in sports as well.

Less commonly, tendonitis can be caused by a sudden, unexpected forceful load on the tendon. There are also risk factors which are unrelated to overuse. The causes and risk factors of Tendonitis are:

● Overuse and repetitive motion of the muscle of the affected tendon in your job or sports-related activity
● Overuse from other activities such as gardening, raking, knitting, typing, painting, woodworking and other manual work
● Less commonly, direct trauma to the joint/tendon may incite tendonitis
● Increased age
● Improperly warming-up before engaging in strenuous activity
● Improper athletic technique
● Certain medications such as steroids
● Smoking and excessive alcohol use
● Certain medical condition which cause weakening of the muscle and tendon such as Gout, Rheumatoid ● Arthritis, and certain blood diseases

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What are Symptoms of Dupuytren’s Contracture?

Some signs and symptoms that you may experience with Tendonitis are:

● Joint pain, depending on the location of the injury
● You may have heard a popping sound at the time of injury
● A grating or grinding sensation when moving the area affected
● Swelling and bruising
● Pain that worsens with using the muscle associated with the affected tendon
● Weakness noticed with any of the above activities

Treatments for Tendonitis

The treatment for Tendonitis is almost always conservative. The treatment involves:

● Discontinuation of the aggravating activity, allowing the tendons to rest
● NSAIDs (nonsteroidal anti-inflammatory drugs)
● Cortisone injections
● Physical therapy: there are many exercises that a patient will be instructed to perform in physical therapy with the focus on eccentric exercises. Eccentric exercises are a form of strengthening the muscle as it lengthens, as opposed to a concentric contraction as in a biceps curl, when the muscle is shortening as it contracts. Eccentric exercises have been proven to be quite effective in managing the pain of tendon injuries. Deep tissue and transverse friction massage are also modalities that physical therapists frequently use when treating tendon injuries

There are more invasive options that may be considered when the progression of this condition is very advanced and conservative treatment fails to reduce pain and improve function. These are Dry Needling, Ultrasonic treatment, or surgery in the case of a badly damaged or torn tendon.

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