12 Apr Dealing With Tendonitis

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Ever heard of the tennis elbow, golfer’s elbow, swimmer’s shoulder, and jumper’s knee? You may have heard of these from people who have complained about some body part that involves a joint. All these conditions are some form of tendonitis. Tendonitis, also known as tendinitis, is the inflammation of the tendons. Tendons are those strong bands of tissue that connect muscle to bone. Over time, when these get overused by poorly executed exercise forms, repetitive movements in sports, or heaviness from obesity, these tendons get strained and develop small tears.

Depending on its severity, tendonitis can be a very painful condition. Its main symptoms are pain and tenderness at the location of the tendon and the area around it. The most common areas for tendonitis to develop are: knees, shoulder, wrist, shin, heel, base of thumb and the hip. The pain in any of these areas may gradually build up or occur suddenly, especially if there is a calcium accumulation in the area as well. Other symptoms that may accompany pain and swelling are: tenderness and redness, stiffness in the joint area, immobility, crackling or grating feeling when the tendon is set to motion, a lump on the tendon, weakness of the muscle, and local warmth to the skin overlying the injured tendon. Tendonitis is a common diagnosis in sports medicine and Buffalo Back & Neck Physical Therapy can really help with this.

The traditional view of tendonitis is a tendon injury resulting from repetitive mechanical load with a subsequent inflammatory response. The English literature from 1966 to the present on the etiology, diagnosis, and treatment of tendonitis was evaluated. There is some scientific support in the literature for the diagnosis of tenosynovitis and tendinosis as a pathologic entity. Actual inflammation of tendon tissue consistent with tendonitis has not been seen clearly in patho-anatomic studies. Conclusive evidence confirming that repetitive mechanical load is a major etiologic factor could not be found. Similarly, strength deficits, inflexibility, and improper equipment have not been studied in a controlled prospective manner. Other factors such as age and tendon vascularity have been consistently correlated with these injuries although their overall importance remains difficult to assess.

Treatment with anti-inflammatory drugs has been studied extensively. However, only nine of 32 studies are prospective and placebo controlled. Some pain relief was found in five of the nine controlled studies, but healing of the tendon problem was not studied in these short follow-up studies. Twenty-three studies on steroid injections were found. Eight were prospective and placebo-controlled studies, with three showing beneficial effects of the injection at follow-up.

Much of the pathology and etiology of tendonitis remains unclear.  Physical therapy remains as a standard of care in the resolution of resultant pain, stiffness / range of motion loss, weakness, and scar tissue formation.  It is evident that anti-inflammatories and injectable corticosteroids can assist as useful adjuncts to the treatment.  Unfortunately, the possibility must be considered that current treatment methods may not significantly affect the natural history.

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