Tendonitis : Symptoms, Causes & Treatment

What is Tendonitis?

Tendonitis is inflammation or irritation of a tendon that is the thick fibrous cord that attached muscle to the bone. The condition causes pain and tenderness just outside a joint. Tendonitis can occur in any of your tendons, it’s most common around your shoulders, elbows, wrists, knees, and heels. Pain is often described as a dull ache, affected limb. The area with tendinitis is tender to the touch [1].

Causes and Risks of Tendonitis Pain

One of the main factors that triggered or caused tendonitis pain is repetitive motion like throwing, extensive kneeling, leaning elbows etc. This is repetitive movement of tendons is linked with the greater wear and tear of the tendons leading to the tendonitis. Moreover, repetitive movements result in the greater friction and reduced fluid in the joint that causes inflammation and tendonitis in the tendons [2]. 

Inflammation is the primary cause of the tendonitis as it is associated with the inflammation in the tendon due to any reason. Most of the studies confirmed that tendonitis is caused by a sudden injury that causes inflammation in the tendon. However, there may be any other reasons also that can lead up to the inflammation such as local injury, blood cells infections etc. [1] 

Most people develop tendonitis because of their jobs and hobbies which involve repetitive motions, which put stress on the tendons. According to a recent study, tendonitis is mostly diagnosed among the athletes because their tendons are at greater pressure for prolonged time or at regular intervals [3]. 

Moreover, the use of antibiotics belonging to the group known as fluoroquinolones can cause tendonitis. Some of the common antibiotic names in this group include ciprofloxacin and levofloxacin [3].

Normal Healing Cycle

The normal healing cycle is divided into three overlapping stages. Inflammation, proliferation, and maturation

  1. The inflammation phase includes swelling, pain, redness, temperature, and loss of function. This stage play important role in healing as the swelling prevents the other tissues from being damaged, disposal of pathogens through increased temperature, and alerting the white blood cells to start the healing cycle [4].
  2. In the proliferation stage, the accumulation of scar tissues occurs at the affected area so that the healing process is followed by fascia restrictions and muscle spasms. If the scar tissue formation doesn’t occur then the healing cycle can’t get started [4].
  3. The last stage is the maturation stage in which scars tissue is replaced by skin tissues and the healing process is completed.

Normal Healing Cycle in Tendonitis

The normal healing cycle is a little different from the healing cycle in tendonitis because the blood supply to tendons is usually low than the others areas hence takes more time to heal. Most damage heals in about two to four weeks, but chronic tendinitis can take more than six weeks [4].

Not effective Treatment for Tendonitis

Most of the regular treatment for tendonitis is not effective.

  1. Heat and cold therapy are not so effective in tendonitis because heat and ice therapies usually relieve muscle and tissues due to fatigue and physical stress.
  2. Electronic stimulation (E-stim) has been widely used in hand therapy to promote recovery after tendon injuries.
  3. Form rollers refer to the self-myofascial release technique but this physical relief therapy is not much effective for tendonitis.
  4. Massage and stretching are effective for tendonitis. Massage therapy reduces swelling, improves circulation, and helps to restore mobility of that area. It combines firm pressure and slow strokes to reach the deep layers of muscle and fascia, treating chronic pain but cannot fully treat the pain and the stretching is not always effective, the more severe the tendonitis, the less likely stretching would help. Stretching results in further compression of the tendon at the irritation point, which worsens the pain [5].
  5. Strength exercises are not good because they can cause inflammation, redness, and swelling during an inflammatory stage in tendonitis.

Effective Treatment for Tendonitis

Inflammation stage:

The best way to treat tendonitis in this stage is to stop doing repetitive motions for a few days and take complete rest so that pressure should not be applied to the affected area. If the inflammation doesn’t reduce in three to four days then you have to treat it a little bit aggressively. MagnaHeal is a more effective way to treat tendonitis because it consists of magnets that attracts the tissues and make space between them. It is also seen that an anti-inflammatory diet is also good as others. One should not choose a diet that can cause inflammation [6].

If the chronic tendonitis is not healing rapidly so there is a chance that there is vitamins, minerals, and hormonal imbalance. Because they help in the stages of the healing cycle. Because if there is deficiency there will be back and forth between inflammation and proliferation stage.

Proliferation stage

The proliferation stage treatment is divided into scar tissue release, trigger point release, and fascia release. A3 and A5 are designed for positioning the soft tissues by applying pressure. Scar tissue release is done by A3 to align the superficial tissue and trigger point release is done by A5 which is designed to deeply treat the tissues. Fascia release is based on fascia layers. Fascia layers are composed of superficial and deep (aponeurotic, epimysium, perimysium, and endomysium) layers. A1 is used for treating superficial fascia restrictions and A5 for deep fascia restrictions which soften the fascia tissues [6].

Bottomline

Tendonitis is a chronic and painful disease that causes inflammation in the tendons. Tendonitis can be treated by a physiotherapist or professional therapist who will use different therapies (MagnaHeal, A1, A3, and A5) to treat tendonitis.

References 

  1. Cardoso TB, Pizzari T, Kinsella R, Hope D, Cook JL. Current trends in tendinopathy management. Best Practice & Research Clinical Rheumatology. 2019 Feb 1;33(1):122-40.
  2. DeMaio M, Paine R, Drez DJ. Achilles tendonitis. Orthopedics. 1995 Feb 1;18(2):195-204.
  3. Andarawis‐Puri N, Flatow EL, Soslowsky LJ. Tendon basic science: Development, repair, regeneration, and healing. Journal of orthopaedic research. 2015 Jun;33(6):780-4.
  4. Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British journal of sports medicine. 2009 Jun 1;43(6):409-16.
  5. Li HY, Hua YH. Achilles tendinopathy: current concepts about the basic science and clinical treatments. BioMed research international. 2016 Nov 3;2016.
  6. Malliaras P, Barton CJ, Reeves ND, Langberg H. Achilles and patellar tendinopathy loading programmes. Sports medicine. 2013 Apr;43(4):267-86.