Tendonitis is the term for inflammation or irritation of a tendon that causes pain and tenderness. It can occur in any tendon in the body, but tends to be most common in shoulders, elbows, wrists, and heels. Tendonitis is also sometimes called tendinitis.
How Do I Know if I Have Tendonitis?
You may have tendonitis if you have pain in a limb or joint and feel the pain most when you move that part of your body. The area might also be tender, and you may have swelling. Your sports medicine doctor can usually diagnose tendonitis with a physical exam, but may prescribe other tests (such as X-ray or MRI) to make sure you don’t have another injury.
What Causes Tendonitis?
Tendonitis is most often caused by overuse or repetitive motion. An athlete who performs the same skill over and over again can strain certain tendons. Tennis players and baseball players, for example, are at risk of tendonitis in the elbow; and swimmers may develop it in their shoulders.
Tendonitis can develop when tendons that are not accustomed to certain activities regularly are overused, as well. This commonly occurs in patients who overdo sports or exercise on the weekends with little activity during the week to strengthen the tendons and muscles. Tendonitis can also be a result of incorrect posture or insufficient conditioning prior to exercising or playing sports.
Other contributors to tendonitis can include:
- Stress from another medical condition, such as rheumatoid or psoriatic arthritis,
thyroid disorders, or gout
- Unusual reaction to medication
- Abnormal bone or joint placement which can stress the soft tissue structures (ex.
leg length differences)
- Infection, particularly from a dog or cat bite
- Common repetitive motion activities that can result in tendonitis include:
- Gardening, raking, or shoveling
- Excessive vacuuming or other household chores
Common Types of Tendonitis
Shoulder tendonitis: Affects the tendon of the supraspinatus or infraspinatus muscles located in the rotator cuff
Elbow tendonitis: Can occur on the outer side of the elbow (lateral epicondylitis or tennis elbow) or on the inner side of the elbow (medial epicondylitis or golfer’s elbow)
Wrist tendonitis: Often presents as de Quervain’s Tenosynovitis, causing pain in the thumb side of the wrist
Knee tendonitis: Knee injury that commonly involves the patellar tendon (lower portion of kneecap) or quadriceps tendon (upper kneecap) and is frequently seen in runners or basketball players
Tendonitis of the Achilles tendon: Typically, an overuse injury (but can be caused by ill- fitting shoes or poor running technique) that affects the ropelike tendon which is attached to the heel bone and runs up to the calf
Trigger finger or trigger thumb: Occurs when the tendon sheath in the hand becomes thickened and/or inflamed keeping the tendon from moving smoothly and the finger or thumb in a bent position
How Is Tendonitis Treated?
Though tendonitis can be a hassle, causing pain and keeping you away from activities, treatment is often simple. It starts with an effort to reduce inflammation, and thereby pain. Your sports medicine doctor will first recommend resting and taking over-the-counter anti-inflammatory medications and/or anti-inflammatory creams. As well, he or she may have you use the RICE orthopedic injury treatment if the injury is new or severe.
If you need more aggressive treatment, your doctor may inject your tendon with cortisone to reduce inflammation or use ultrasound to promote healing. Physical therapy may also be used as part of your treatment and rehabilitation, with the goal of stretching and strengthening the injured tendon. In more severe cases, tendonitis can be repaired with surgery.
Goals of tendonitis treatment include:
- Allow adequate time to rest the affected tissue
- Restore pain-free joint movement
- Maintain surrounding muscle strength
Physical therapy plans may involve ultrasound or whirlpool treatments to relax tendons and muscles, as well as improve circulation to promote faster healing. Activity should be resumed gradually and stopped at the first sign of pain as not to re-injure the affected tendon. Returning to activity too soon or not seeking treatment for tendonitis can result in chronic overuse tendinopathy and/or torn tendons.
When to Call Your Doctor About Tendonitis
Tendonitis can take several weeks or months to go away completely. If your pain does not improve within 7-10 days after using the RICE method and over-the-counter medications, you should contact your sports medicine doctor.
You should also seek medical attention about tendonitis if:
- You have fever over 100°F
- Your joint is red, swollen, and warm to the touch
- You are unable to move the affected area
- Your pain is severe or worsens after home treatment