What are tendons?

Tendons are the white fibrous tissues which connect your muscles to your bones. To move any part of your body you send a signal to your muscles to pull on your bone - and it is the tendon which transmits this pulling force.
Tendons come in many shapes and sizes. Some, like the ones that cause movements of your fingers, are very small, and some are much larger. You will be able to see various of your tendons through the skin - the most easily identified if the Achilles tendon, which runs from the back of your calf to your heel
When functioning normally, your tendons glide easily and smoothly as the muscle contracts. In some cases a tendon will run within a sheath.

What is Tendonitis?

When a tendon or its sheath becomes inflamed it is called tendonitis. The tendons can become irritated or inflamed for a variety of reasons, and the action of pulling the muscle becomes difficult. 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, which literally means 'inflammation of the tendon'.

Tendonitis usually causes one or more of the following symptoms:

  • a sharp or achy pain,
  • tenderness and swelling,
  • restricted movement in the area surrounding the injury, or
  • weakness in the arm or leg due to pain.
 Common sites of tendonitis include the following: 

What causes Tendonitis?

The most common cause of tendonitis is overuse. Often, people either begin an exercise programme, or otherwise dramatically increase their level of physical labour and soon after begin to experience symptoms of tendonitis. The tendon is simply not used to doing so much work and becomes inflamed because of this.
Any activity that requires repetitive motion of the elbow such as bowling, manual labor or even housework can cause the injury. Tendonitis can occur after an injury or, in rare cases, it may result from a disease.

Tendonitis can also be associated with a calcium deposit, which can cause inflammation. 

Achilles tendonitis can be caused by physical activities such as running and aerobics. Wearing shoes that are not well-cushioned and exercising on a hard surface can also irritate the condition by causing a strain or tears in the tendon.  

Other causes of tendonitis include:

  • poorly-fitted shoes that rub against foot tendons,
  • bone spurs in the feet or elsewhere that irritate tendons,
  • obesity, which puts abnormal pressure on the legs and feet,
  • repeated overuse of the wrist, which can inflame the tendons,
  • overuse of the tendons in the shoulder, sometimes seen in swimmers
  • overuse in the serving arm of a tennis player, and
  • overuse of arm muscles, which can cause inflammation of tendons in the
  • elbow, commonly called tennis elbow.

Another common cause of symptoms of tendonitis is age-related changes in the tendon. As people age, the tendons loose their elasticity and ability to glide as smoothly as they used to and people become more susceptible to tendonitis. 

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.  

What are the possible complications of tendonitis?

If tendonitis remains untreated the tendons can become weak, which makes them more susceptible to tears and ruptures.

Tissue degeneration, characterised by cell atrophy, can also happen. Calcium can deposit along the course of the tendon ( calcific tendonitis), with the shoulder being the most common site.

How can I avoid Tendonitis?

Here are some guidelines to help you avoid tendonitis

  • gradually build up the intensity and frequency of exercise
  • warm up and cool down before and after exercise
  • choose shoes that fit properly
  • if you sit at a desk for many hours, make sure you change your position and posture to reduce stress to one area, pace yourself, and take frequent breaks

The key to avoiding problems such as tendonitis is to slowly increase the intensity of your exercise, vary the types of exercise, and try not to cycle between periods of activity and inactivity. People who tend to experience tendonitis are seasonal exercisers, who focus too much on one activity. When you begin to experience early symptoms of tendonitis is, back off from the aggravating exercise, and try something new.

And remember, "exercise" means any physical activity, not just going to gym.

How can I treat Tendonitis?

As soon as you feel you may have an irritated tendon, it is a good idea to:

  • Rest the affected area completely
  • Treatment of inflammation of the tendon 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
  • apply ice to the affected area for the first 24 to 48 hours,
  • Applying an ice pack will help stop the internal bleeding and reduce swelling. 
  • after 48 hours, apply moist heat for deep muscle relaxation
  • use an over-the-counter anti-inflammatory pain reliever
     Talk to your chemist about the best one to use, remembering to tell him or her anything which might affect the drugs you can safely take. Remember, pregnant women should always talk with a trusted chemist, or preferably their GP before taking any drugs of any kind 

Other means of treatment include, ultrasound therapy, myotherapy and many alternative treatments.  Working to stretch and strengthen muscles in the area of the tendonitis can be helpful. As stated earlier, surgery is occasionally needed, but only after these non-surgical treatment measures have failed to work.

It is also recommended 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.

Acute tendonitis often subsides within 10 to 14 days. If the pain continues after home care for 14 days, or worsens, a doctor should be consulted.

How can my doctor treat tendonitis?

When you take your tendonitis to your doctor, he may recommend: 

Inflammation can also be treated with some medications, including non-steroidal anti-inflammatory medications. These medications can be very helpful both in relief of pain and in reduction of the inflammation. Other possible medications to use are steroid injections

Now my tendonitis is gone, will it come back?

Not necessarily, but it certainly may. If you do experience tendonitis, you are more likely to have symptoms again down the road, but with an intelligent approach to your exercise routine, this problem can often be avoided.

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