Tendonitis

What is tendonitis?

Tendonitis (tendinitis) is the inflammation or irritation of a tendon that makes it swell. Tendons are strands of connective tissue between muscles and bones that help you move. This condition usually happens after a repetitive strain or overuse injury. It’s common in your shoulders, elbows and knees. If you have tendonitis, you’ll feel pain and soreness around your affected joint, usually near where the tendon attaches to the bone. Tendonitis can be either acute (short-term) or chronic (long-term).

Types of tendonitis

Types of tendonitis get their names after sports and the area of your body where injuries happen. Some of the most common types of tendonitis include:

• Tennis elbow.
• Golfer’s elbow.
• Pitcher’s shoulder.
• Swimmer’s shoulder.
• Runner’s knee (jumper’s knee).

How common is it?

Tendonitis is a relatively common condition. This is because people participate in occupations, activities or hobbies where they can easily overuse or injure their tendons.

What are the symptoms of tendonitis?

The most common symptoms of tendonitis include:

• Pain at the site of your tendon and the surrounding area. This pain can get worse when you move.
• Stiff joints or difficulty moving your joints.
• Hearing and feeling a cracking or popping sensation when you move.
• Swelling, often with skin discoloration (red to purple or darker than your natural skin tone).

The pain you feel with tendonitis may be gradual or sudden and severe, especially if you have calcium deposits. Calcium deposits are a buildup of calcium in your tissues that looks like firm white to yellow bumps on your skin. These bumps can cause itchy skin.

Where on my body will I have symptoms of tendonitis?

Tendinitis can occur in almost any area of your body where a tendon connects a bone to a muscle. The most common places are:

• Base of your thumb.
• Elbow, usually along the outer part of the forearm, when your palm is facing up, near where the tendon attaches to the outside part of the elbow.
• Shoulder.
• Hip.
• Knee, usually below the kneecap where your tendon attaches to your lower leg (tibia).
• Achilles tendon, which connects your calf muscles to your heel bone.

What causes tendonitis?

Causes of tendonitis could include:

• Overuse or repetitive movements over time (like running or throwing).
• Strain from sudden movements.
• An injury.

In addition, tendonitis could be a side effect of a medication, including statins or drugs that lower cholesterol or fluoroquinolone antibiotics.

Certain underlying medical conditions can also cause tendonitis, such as:

• Diabetes.
• Rheumatoid arthritis.
• Gout/pseudo gout.
• Osteoarthritis.
• An infection.

What are the risk factors for tendonitis?

Anyone can get tendonitis. But it’s more common in those who do repetitive activities. Some of these activities include:

• Gardening/landscaping.
• Woodworking.
• Shoveling.
• Painting.
• Scrubbing.
• Playing sports like tennis, golf or baseball.

Other risk factors for tendonitis include:

• Poor posture.
• Presence of certain conditions that can weaken your muscles.
• Your age. After age 40, your tendons tolerate less stress, are less elastic and tear more easily.

What are the complications of tendonitis?

If left untreated, tendonitis could lead to:

• Chronic tendonitis (a constant, dull pain when you move).
• Difficulty or inability to move the affected part of your body.
• Torn tendons (tendon rupture).
• Muscle weakness.

How is tendonitis diagnosed?

A healthcare provider will diagnose tendonitis after a physical exam and testing. During the exam, your provider will take a complete medical history and ask you questions about your symptoms. They’ll order tests to confirm a diagnosis. Imaging tests help your provider see your tendons and could include:

• An X-ray.
• An MRI (magnetic resonance imaging).

How is tendonitis treated?

There are two steps to treat tendonitis. The first step includes:

• Icing the area the day of your injury.
• Avoiding activities that cause symptoms.
• Resting the injured area.
• Taking over-the-counter (OTC) anti-inflammatory medicines.

If tendonitis doesn’t improve in about three weeks, a healthcare provider will offer additional treatment that could include:

• Corticosteroid injections: Corticosteroids (often called “steroids”) work quickly to decrease the inflammation and pain in your tendon.
• Physical therapy: Physical therapy includes range of motion exercises and splinting (thumb, forearm or hands). Physical therapy will focus on reducing inflammation, improving soft tissue mobility to the muscle (where that tendon originates from), and restoring movement, function and strength over time. With tendinitis-type injuries, a gradual loading of the tendon (eccentric loading), is essential to improving the condition and restoring function. Therapy may also be useful in screening other joints for mobility deficits that may have led to the development of tendonitis. A common example is looking at shoulder mobility when working with a person who has a tennis elbow.
• Surgery: This is rarely needed and is only for severe symptoms that don’t respond to other treatments.

Are there side effects of the treatment?

Before you begin treatment, talk to your healthcare provider about possible side effects. You may experience:

• Pain at your injection site if you receive corticosteroid injections.
• Soreness after physical therapy.
• Bleeding or an infection after surgery.

How long does tendonitis take to heal?

It could take between two to three weeks for your tendon to heal after tendonitis treatment. It can take a few months if you have a severe case of tendonitis. The best way to speed up your healing time is to rest. Don’t participate in strenuous exercises or activities that can put stress on your healing tendon. Your healthcare provider will let you know when it’s safe to return to your favorite sports and activities after your tendon heals.

What can I expect if I have tendonitis?

Most people diagnosed with tendonitis have an excellent prognosis after treatment and rest. It may take a few weeks to a couple of months to recover from tendonitis, depending on the severity of your injury. Wait until your healthcare provider gives you the “all clear” to resume your regular physical activities.

If you develop tendonitis and receive treatment for it, you can get the injury again in the future if you put too much stress on your tendons. This is a repetitive strain injury. Your healthcare provider, sports medicine physician or physical therapist can give you advice to reduce your risk of developing repeat tendonitis in the future.

Can I prevent tendonitis?

To avoid getting tendonitis, follow these tips:

• Avoid staying in the same position. Take breaks every 30 minutes.
• Learn proper posture and body positions for all activities.
• Position your body directly in front of the object you want to pick up. Reach for the object by stretching your arm and hand directly forward toward the object. Never grab objects with your arm in a sideways position. If reaching for an object overhead, center your body and reach up and grab the item with both hands.
• Use a firm, but not a tightly squeezed, grip when working with or picking up objects.
• Don’t use one hand to carry heavy objects. Don’t hold the heavy object in one hand at the side of your body.
• Avoid sitting with your leg folded under your bottom.
• Stop any activity if you feel pain.

How can I lower my risk of tendonitis?

You can reduce your risk of developing tendonitis by following these steps before exercising or starting a sports activity:

• Stretch and warm up before starting the activity.
• Wear properly sized and fitted clothes, shoes and equipment.
• Start slow. Gradually increase your activity level.
• Stop your activity if you feel pain.

When should I see a healthcare provider?

You should see a healthcare provider if you experience any of the following:

• Fever (over 100 degrees Fahrenheit or 38 degrees Celsius.).
• Swelling, redness and warmth.
• General illness.
• Multiple sites of pain.
• Inability to move the affected area.

These could be signs of another condition that needs more immediate attention.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Do I have tendonitis or arthritis?
• When can I return to playing sports or exercising?
• Are there side effects of the treatment?
• Do I need surgery?