Tendonitis

There are several risk factors for developing tendonitis, such as age, working in particular jobs, or participating in certain sports. Other contributing factors may include:

• Incorrect posture at work or home,
• Poor conditioning before exercise or playing sports,
• Abnormal or poorly placed bone or joint that stresses soft tissue structures (e.g., arthritis),
• Stresses from conditions such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, or unusual medication reactions,
• Overuse or doing too much too soon when the tendons aren’t used to making a movement or doing the task taken on (e.g, “weekend warrior”).
• Infection from a cat or dog bite to the hand or finger.

Anyone can get tendonitis, but adults over age 40 are most susceptible. As you age, the tendons tolerate less stress, are less elastic, and are easier to tear.

Athletes are also more prone to developing tendonitis. You may have heard of some common sports injuries involving the tendons, such as jumper’s knee, tennis elbow, golfer’s elbow, and pitcher’s shoulder. These sports injuries occur from overuse, and as a result the tendons become inflamed.

Tendonitis can occur in any part of the body where a tendon connects to a bone or muscle. The most common places are:

• Base of the thumb
• Elbow
• Finger
• Shoulder
• Hip
• Knee
• Achilles tendon

Symptoms of tendonitis include

• Acute, centralized pain at the site of the tendon and surrounding area
• Tenderness
• Swelling
• Loss of motion (e.g., frozen shoulder)

Tendonitis is typically diagnosed by a physical exam alone. Your doctor may also order an ultrasound or MRI scan to help determine tendon thickening, dislocations, and tears to rule out one condition over another or to confirm a diagnosis or degree of tendonitis.

The goal of treatment is to restore movement to the joint without pain and to maintain strength in surrounding muscles. 

Initial treatment of tendonitis includes things you can do at home, such as

• Resting
• Avoiding activities that aggravate the problem
• Icing the area the day of the injury to numb pain and cause blood vessels to constrict to reduce swelling
• Applying heat after 3 days to increase blood flow to an injury and help promote healing
• Elevating the injured tendon
• Taking over-the-counter anti-inflammatory drugs or using topical anti-inflammatory gels

If these at-home treatments don’t help, you should see your doctor for more advanced treatments to avoid a ruptured tendon or surgery. Treatment options include:

• Corticosteroid injections. These injections work quickly to decrease inflammation and pain, but they are not recommended for chronic cases of tendonitis.
• Physical therapy. Focuses on an exercise plan that rests the tendon while strengthening nearby muscle groups and maintaining overall muscle tone.  Eventually, you will begin to exercise the tendon itself, using a program of eccentric exercises in which you gradually strengthen the muscle while stretching, and stopping at the first sign of pain. Easy stretching exercises may also be recommended for you to do several times a day. Other range-of-motion exercises may be recommended for issues with a frozen shoulder.
• Splints. Designed to immobilize, reduce swelling, and alleviate pain.
• Ultrasound and whirlpool treatments. Relaxes muscles and tendons, improving circulation and promoting health.
• Surgery. Recommended for severe problems (chronic conditions) not responding to other treatments.

The recovery period for tendonitis usually depends on the severity and location of your injury; however, for minor injuries, it can take up to 2 weeks to heal and for more severe damage to the tendons it may take up to 4 to 6 weeks. Ultimately, your doctor will let you know how long it will take to recover from your injury.

If tendonitis is left untreated, it could develop into tendinosis, which is a long-term, chronic, and degenerative version of tendonitis.

Also, if you experience any of the following, it could be a sign of another problem that needs more immediate attention. See your doctor if you have

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

When starting up a new activity or exercise program, follow these tips to avoid tendonitis:

• Startup slowly and gradually buildup to your desired activity level.
• Vary your routine and gently stretch all the muscles and tendons you plan to exercise,
• Limit repetitions.
• Wear appropriate footwear.
• Stop if pain occurs. Do something else.