Tendonitis, also known as tendinitis, is when the tissues that connect your muscles to your bones (tendons) become inflamed. It often occurs due to repetitive activities and can be quite painful. Tendonitis can affect various parts of your body, including the elbow, knee, shoulder, hip, Achilles tendon, and the base of your thumb. Rest and avoiding strenuous activities are essential for the healing of tendons.
What is Tendonitis?
Tendonitis, or tendinitis, is the swelling and irritation of a tendon, which is a connective tissue that links muscles to bones, enabling movement. It typically occurs after repetitive strain or overuse, commonly affecting the shoulders, elbows, and knees. Tendonitis can be either short-term (acute) or long-term (chronic).
Types of Tendonitis
Various types of tendonitis are named after sports and the specific body areas where injuries occur. The most common types include:
- Tennis elbow
- Golfer’s elbow
- Pitcher’s shoulder
- Swimmer’s shoulder
- Runner’s knee (also known as jumper’s knee)
Tendonitis is relatively common because people engage in activities or jobs that can lead to overuse or tendon injuries.
Symptoms and Causes
What are the Symptoms of Tendonitis?
Common symptoms of tendonitis include:
- Pain at the tendon site and the surrounding area, which worsens with movement
- Stiff joints or difficulty moving them
- The sensation of cracking or popping when moving
- Swelling, often with a change in skin color, appearing reddish, purplish, or darker than your natural skin tone
Tendonitis pain can develop gradually or suddenly and can be severe, especially when there are calcium deposits. Calcium deposits are accumulations of calcium in your tissues, appearing as firm, white to yellow bumps on your skin, potentially causing itching.
Where in the Body Does Tendonitis Occur?
Tendonitis can affect nearly any part of your body where a tendon connects a bone to a muscle. Common areas include:
- The base of your thumb
- Elbow (usually on the outer part of the forearm, near where the tendon attaches to the outer part of the elbow when your palm is up)
- Knee (typically just below the kneecap where the tendon connects to the lower leg)
- Achilles tendon (connecting your calf muscles to your heel bone)
What Causes Tendonitis?
Tendonitis can result from:
- Overuse or repetitive movements over time, such as running or throwing
- Strain from sudden, forceful movements
- Medications, including cholesterol-lowering drugs (statins) or fluoroquinolone antibiotics
Some underlying medical conditions can also lead to tendonitis, including diabetes, rheumatoid arthritis, gout/pseudo gout, osteoarthritis, and infections.
What Are the Risk Factors for Tendonitis?
Tendonitis can affect anyone, but it’s more common in people engaged in repetitive activities. Some risk factors include:
- Sports like tennis, golf, or baseball
- Poor posture
- Underlying conditions that weaken muscles
- Age: Tendons become less resilient and more susceptible to tearing after age 40
What Are the Complications of Tendonitis?
If left untreated, tendonitis can lead to:
- Chronic tendonitis (constant, dull pain during movement)
- Difficulty or inability to move the affected body part
- Torn tendons (tendon rupture)
- Muscle weakness
Diagnosis and Tests
How Is Tendonitis Diagnosed?
Healthcare providers diagnose tendonitis through a physical examination and tests. During the exam, your provider will take your medical history, ask about your symptoms, and order tests to confirm the diagnosis. Imaging tests, such as X-rays and MRIs, help providers visualize your tendons.
Management and Treatment
How Is Tendonitis Treated?
The treatment of tendonitis involves two steps:
- Initial Treatment:
- Applying ice to the affected area on the day of the injury
- Avoiding activities that cause symptoms
- Resting the injured area
- Taking over-the-counter anti-inflammatory medications
- Additional Treatment:
- If tendonitis doesn’t improve within about three weeks, healthcare providers may offer further treatment, including:
- Corticosteroid injections to reduce inflammation and pain
- Physical therapy, which may include exercises and splinting
- Surgery (rarely needed and reserved for severe cases that don’t respond to other treatments)
Are There Side Effects of Treatment?
Before starting treatment, discuss potential side effects with your healthcare provider. Possible side effects may include pain at the injection site with corticosteroid injections, soreness after physical therapy, and bleeding or infection after surgery.
How Long Does Tendonitis Take to Heal?
Tendonitis may take two to three weeks to heal with treatment. Severe cases may require a few months. Rest is crucial for a faster recovery. Avoid strenuous activities that could stress the healing tendon, and only resume your regular sports and activities when your healthcare provider gives the green light.
Can Tendonitis Be Prevented?
To prevent tendonitis, consider the following tips:
- Avoid staying in the same position for extended periods; take breaks every 30 minutes
- For all activities, learn good posture and body postures.
- Use the correct technique for lifting objects
- Maintain a firm, but not overly tight, grip when working with or picking up objects
- Avoid carrying heavy objects with one hand
- Don’t sit with your leg folded under your bottom
- Stop any activity if you feel pain
How Can You Lower the Risk of Tendonitis?
Reduce your chances of acquiring tendinitis by taking the following precautions before beginning an exercise or sports activity:
- Stretch and warm up before your activity
- Use properly sized and fitted clothes, shoes, and equipment
- Begin gradually and increase your activity level slowly
- Stop any activity if you feel pain
Outlook / Prognosis
What Can You Expect if You Have Tendonitis?
Most people with tendonitis have a good prognosis after treatment and rest. Recovery may take a few weeks to a couple of months, depending on the severity of the injury. It’s important to wait for your healthcare provider’s clearance before returning to your regular activities to prevent recurrent tendonitis.
If you’ve had tendonitis and received treatment, you can reduce the risk of future tendonitis by following advice from your healthcare provider, sports medicine physician, or physical therapist.
When Should You See a Healthcare Provider?
Consult a healthcare provider if you experience:
- Fever (over 100°F or 38°C)
- Swelling, redness, and warmth
- General illness
- Pain in multiple areas
- Inability to move the affected area
These could be signs of another condition requiring prompt attention.
What questions should I ask my doctor?
- Do I have tendonitis or arthritis?
- When can I return to playing sports or exercising?
- Are there side effects of the treatment?
- Do I need surgery?
A note from Greendale Physical Therapy:
Tendonitis can be a frustrating condition. You’ll need to stop and rest for a few weeks to let your tendon heal after an injury that causes it to swell. This can be challenging if you’re an active person or you play sports. Don’t return to the track or field until your healthcare provider tells you it’s safe to do so. Follow your provider’s instructions to prevent injuries that lead to tendonitis.