Tendonitis & Overuse Injuries

Tendonitis

Tendonitis refers to the inflammation of a tendon, which is a band of fibrous connective tissue that attaches a muscle to a bone. Tendonitis can result from repetitive or overuse injuries and can occur during activities such as gardening, carpentry, shoveling, painting, scrubbing, tennis, golfing, skiing, and pitching. People with poor posture or those who avoid stretching before exercise are at a higher risk of developing tendonitis. Tendonitis can also affect individuals with rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, infections or an unusual medication reaction.

Tendonitis can affect individuals of any age but is more common in adults over the age of 40 years, as tendons lose their strength and elasticity with age, and become susceptible to tear. Tendonitis can affect any tendon; however, it commonly involves the shoulder, elbow, base of the thumb, hip, knee and the heel (Achilles tendonitis).

The predominant symptom is pain at the site of the injured tendon. The pain may occur suddenly or develop gradually and may be severe. The motility of the joint, close to the affected tendon, may also be affected.

The initial treatment of tendonitis includes rest, avoiding activities that worsen the condition, application of ice to the affected area, and anti-inflammatory medications. Corticosteroid injections, physical therapy, and surgery may be considered if the symptoms of tendonitis persist and do not respond to the initial line of treatment. Depending on the severity of the damage, the healing period may vary from a few weeks to months. To decrease your chance of developing tendonitis, avoid repetitive movements; stop any activity that causes pain, and gradually increase your activity levels.

Contact your doctor immediately if you have fever, swelling, redness and warmth to the area, multiple sites of pain, or lack of ability to move the involved area.

Overuse Injuries

Overuse injuries result from repetitive activities that cause excess stress on the tissues of the body leading to damage over time. Under normal stress, tissues undergo minor injuries and adaptive changes when they heal. With repetitive stress however, there is little time to heal and injuries lead to tissue degeneration. Overuse injuries may damage muscles, nerves, tendons, ligaments and even bones.

Overuse injuries are commonly associated with sports, often caused by overzealous participation, inappropriate technique and improper equipment. They may also be caused by repetitive activity from other recreational, occupational or habitual activities.

Symptoms include pain, swelling, popping, clicking and erythema (redness). When you present with these symptoms, your doctor will review your history and ascertain the activity causing the injury. A physical examination of the affected area is performed. Imaging studies may be ordered to identify areas of tissue damage or other pathology.

Overuse injuries are usually treated conservatively by first avoiding or modifying the activity causing injury. Physical therapy is often recommended and includes exercises that encourage healing of the tissues, and improve strength and flexibility without causing further injury. Advice on proper technique, use of equipment and prevention of sports injuries may be offered. Occupational and vocational therapy may be recommended to help you return to work and avoid further injury. Surgery is recommended when conservative treatments do not provide adequate relief and a correctable problem is identified. It is usually performed to decompress nerves and repair ligaments.