Tendinitis

Overview of Tendinitis

Overuse injuries are common among professional athletes. According to one recent statistics, every year, nearly 5-10% of the athletes suffer from some of the other forms of musculoskeletal injuries. A common overuse injury that is found in both athletes and non-athletes is “Tendinitis”. It arises due to the tremendous stress occurring in the muscles and joints on a regular basis.

What is Tendinitis?

Tendinitis usually occurs due to rigorous and repetitive movement of the tendons in the shoulders, hands, wrists, and elbows. Due to the swelling of the tendons surrounding a joint, the motion of this joint becomes limited.

As a result of repetitive strain and friction, the tendons develop wear and tear and may eventually lead to immobility. The normal gliding motion of the tendons is disturbed in this disease.

Tendon problems may develop suddenly or may occur progressively over several years. In the cases of extreme severity, medical intervention is always necessary.

What causes Tendinitis?

Tendinitis is an overuse injury. The common precipitating factors of the disease are as follows-

• Damage of the tendons due to overuse and injuries
• A build-up of calcium along the length of the tendons
• Presence of bone spurs (sticking out bony structures) on the heels
• Presence of very tight calf muscles
• Sports activities, leisure activities or occupational hazards that require a lot of running and jumping
• A sudden increase in the amount of exercise or physical activity
• Running on hard and rough surfaces (especially without proper footwear)
• Improper holding and handling of sports equipment such as golf club or tennis racquet
• An incorrect angle of a strike during any sports activity
• Using sports equipment that is very heavy or defective
• Taking part in sports or physical activities without warming up properly
• Sudden lifting of extremely heavy loads (usually one that is beyond one’s capacity)
• Rigorous training schedule for sports continuously for long hours
• Not taking breaks between training sessions or physical activities (causes insufficient healing of the muscles and tendons)
• Physical activities or exercise in very cold temperature
• Poor postures during sleeping, standing, walking or running
• Sitting or standing for a long time (exerts strain on the tendons and muscles)
• Obesity or overweight condition that creates pressure on the joints and tendons
• The weakness of muscles, loss of muscle tone and elasticity due to aging or some existing diseases (Eg: Gout, Arthritis, Diabetes)
• Loose joints
• Birth defects like malformed joints and tendons
• Past injury to the joints and muscles
• Certain medications that affect the muscle and joint health

Symptoms of Tendinitis

The identifiable symptoms of Tendinitis are as follows-

• Pain and inflammation of the muscles of the elbow, shoulder, forearm or legs
• Muscle stiffness and immobility
• Limited movements of the affected joints
• A weakness of muscles and joints
• Tenderness and warmth of the overlying skin
• Redness of the affected region

Shoulder Tendinitis

Shoulder Tendinitis is a common injury in case of sports like tennis, badminton, basketball, and swimming. A repetitive overhead motion of the hands occurs in this case. This exerts a compressive force on the tendons and bursa (cavities present at the joints), which leads to inflammation and swelling. The pain usually starts at the uppermost tip of the shoulder. Then it gradually spreads to the lower portions of the arm. The pain worsens on twisting and bending the arms.

Shoulder tendinitis has the following subtypes-

• Overuse tendinitis: Damage of the bursa and tendons occur during overhead throwing, lifting and golfing. Excessive compressive stress is exerted on the rotator cuffs, causing bruising and inflammation of the tendons.
• Calcific tendinitis: This results due to the accumulation of excess calcium in the rotator cuffs.
• Impingement tendinitis: It occurs due to the narrowing of the space between the coracoacromial arch and the rotator cuff. Sharp pain occurs due to the pressure exerted by the humerus.
• Rotator cuff tear: Severe wear and tear of the rotator cuff tendons occurs in this case due to repeated striking and injuries.

Achilles Tendinitis

Achilles Tendinitis is an overuse injury that causes pain and swelling along the back portion of the leg near the heel. Injury to the Achilles tendon which connects the heel bones to the calf muscles causes tendinitis.

Achilles Tendinitis is of two types-

• Insertional Achilles Tendinitis: It occurs at the lowermost part of the heel, at the region of attachment of the tendons and the heel bone. Bone spurs often result due to calcification of the damaged tendon fibers.
• Non-insertional Achilles Tendinitis: It affects the fibers present in the middle portion of the tendon. Wear and tear of the tendons develop. This results in thickening and swelling of the tendons.

Patellar Tendinitis

It is also known as “Jumper’s knee” disease. Inflammation of the tendon that connects the shinbone (tibia) to the kneecap (patella) occurs in this disease. A very common complication of this disease is “Chondromalacia Patella” in which cracking sounds are produced due to friction during knee movements.

Diagnosis

The following laboratory tests are recommended by doctors-

• Selective tissue tension test (to detect if the tendon is causing the pain)
• Blood/Fluid Test
• X-ray
• MRI scan

Treatment and precautions

Make sure that you go to the doctor in case you have any pain in your – shoulder, elbow, knee, wrist or knee. Don’t ignore the pain. Undergo proper and complete physiotherapy. Use heat compression or cold packs treatment, use any ibuprofen if necessary and splint the affected area.

Preventions –

• Take your exercise routine slowly. Do not exert yourself too much in one go as it can affect the muscle and the tendon.
• Strengthen tendons and balance muscles can be done to prevent tendinitis. This can be done by doing light weight training to improve the strength of the tendons and muscles.
• Ensure that you warm up before any activity as it helps prevent any sudden pressure on the tendons and muscles.

References