Tendonitis

Tendon Injuries

Tendons are tough, flexible, fibrous bands of tissue that connect muscles to bones and help you move. Tendons, like all structures, can be damaged or injured. The types of tendon pathology (tendinopathy) that can develop include:

Tendonitis – Inflammation of the tendon

Tendinosis – Degeneration of the collagen protein that forms the tendon

Tenosynovitis – Inflammation of the fluid-filled sheath which surrounds the tendon

When a cause can be identified, tendon injuries usually occur for one of two reasons:

• Overuse – A particular body motion is repeated too often
• Overload – The level of a certain activity is increased too quickly

The main symptoms of a tendon injury are pain and tenderness in the affected tendon, which is often worse when you move it. Other symptoms can include swelling, ‘grating’ or ‘crunchy’ sensation on movement, and weakness in the affected region. This condition can occur in different parts of the body, but most commonly develops in the shoulder, elbow, wrist, knee and heel.

Shoulder Tendinopathy/Tendonitis – If the rotator cuff tendons are involved, it may be referred to as ‘rotator cuff tendinopathy’ (i.e. supraspinatus tendinopathy, subscapularis tendinopathy, infraspinatus tendinopathy). The most common cause of shoulder tendinopathy is repeated small amounts of trauma (microtrauma) to the rotator cuff tendons. Symptoms can include:

• Shoulder clicking/Shoulder pain when arm is at about shoulder height
• Pain when lying on the affected shoulder
• Shoulder pain when moving your hand behind your head or back

Tennis Elbow (Lateral epicondyle tendinopathy/tendonitis) - Tennis elbow is an injury to the muscles that straighten (extend) the wrist and fingers. The site of injury is often in the proximity of the bony bump outside the elbow (lateral epicondyle) where the muscles are connected to the bone. Common causes of tennis elbow include: Excessive gripping activities, Poor technique (e.g. Serving in tennis), Unaccustomed hand use, Poor forearm muscles strength or tight muscles.

Symptoms can include:

• Pain with any gripping tasks
• Pain with resisted wrist/finger extension

De Quervain’s Tenosynovitis – This condition affects two tendons called the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB), which travel side by side to the thumb. Surrounding these two tendons is a fluid-filled sheath (tenosynovium) that allows them to glide easily back and forth as they move the thumb. In De Quervain’s Tenosynovitis, inflammation of the tendons and the tenosynovium constrict the movement of these two tendons, resulting in irritation. Common causes include: Repeated hand and thumb movements (E.g. Grasping, Pinching, Squeezing), Direct injury to the wrist/tendon resulting in formation of scar tissue, Inflammatory arthritis (E.g. Rheumatoid Arthritis). Symptoms can include:

• Pain and/or swelling near the base of the thumb
• Difficulty moving your thumb and wrist, especially during grasping or pinching tasks
• Creaking noise/sensation when moving the thumb

Achilles Tendinopathy – This condition often results from repetitive stress to the tendon and is often seen in workers/sportspersons that participate in activities involving repetitive action. Although this condition can develop as a result of over-training or a sudden increase in training intensity, more often it occurs as a result of gradual wear and tear of the tendon from overuse.

Some other common causes of Achilles tendinopathy include: change in training surface, hill running and poorly supportive footwear. It has also been found that tight/weak calf muscles, stiff ankle joints, and/or the presence of a bone spur in the heel can increase the likelihood of developing this condition.

Symptoms of Achilles tendinopathy can include:

• Pain and stiffness in the Achilles tendon in the morning
• Pain along the tendon/back of the heel that worsens with activity
• Tenderness/Redness/Warmth/Swollen lump present at the back of the heel
• Severe pain the day after exercising

Patella Tendinopathy (Jumper’s Knee) – The patella tendon is located just below the patella (kneecap). It plays an important role in absorbing forces during jumping/landing activities and transferring these forces to the quadriceps (muscles in front of your thigh).

When the patella tendon is repeatedly strained from excessive jumping/landing activities, the damage occurring in the tendon exceeds the rate of its repair and eventually causes pain and dysfunction. As such, we often see patella tendinopathy in athletes who are involved in sports such as basketball, volleyball, netball, or track and field.

Alternatively, this can also occur in non-athletes or older individuals as a result of degeneration attributed to repetitive stress and small amounts of damage over time.

Symptoms of Patella tendinopathy can include:

• Localised pain/tenderness over the patella tendon
• Pain that is aggravated by activities such as walking downstairs, performing a decline squat, jumping, landing or running
• Stiff patella tendon in the morning
• Thickened patella tendon compared to the unaffected side

Treatment

Here at ThinkPhysio, our physiotherapists are able to accurately assess and diagnose tendinopathies throughout the body, meaning we will be able to properly determine the level and stage of your tendon injury. With this, we will be able work with you to develop a treatment plan that helps to relieve your pain and allow your recovery from that injury. This plan could include hands on treatment and therapeutic modalities, but will also involve prescription of specific exercises that have been proven to relieve pain in tendinopathies as well as to rehabilitate the tendon and the associated muscle.

For more information on the conditions we treat and services we offer, or to book an appointment please call (03)9790 4266 or email: [email protected]