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  Tendonitis

Tendonitis is the inflammation of a tendon. A tendon is the end part of a muscle that attaches the muscle to the bone. A tendon is more rigid and dense. A tendon is the connection that the muscle uses to pull the bones and make the body move. The thickness of the tendon is what makes it strong, but also making it susceptible to small tears that are invisible to the naked eye. These microscopic rips in the tendon cause inflammation and pain – tendonitis.

Tendonitis Joint pain
Tendonitis


Symptoms:

Symptoms of tendonitis are as mild as a small pain and stiffness in the area or the tendon to severe inflammation and immobility. Pain is usually worse after activity with stiffness increasing the next day.

Causes

Tendonitis is caused by repetitive movement or repetitive stress injury. This occurs when the same activity is repeated extensively. The most common areas that tendonitis affects are wrist, ankle, knee, hip, ankle, shoulder, Achilles (heel), leg and elbow. Tennis elbow is tendonitis of the elbow. Patellar tendonitis is also known as jumper’s knee. Athletes who participate in the long jump and hurdle races are most likely to develop patellar tendonitis.

Diagnosis

Diagnosis of tendonitis is made from observing the history of activity and the symptoms that occur during and after an activity. X-Rays and MRIs are used to rule out any bone damage. X-Rays and MRIs do not show the tears to the tendon and can rarely be used to diagnose tendonitis. Sometimes a bone spur can be present on an x-ray, which would indicate an aggravating factor to the tendonitis.

Treatment

Though pain can be managed and eliminated within three weeks, it is important to realize that the tendon is still healing from the microscopic tears. The healing involves scar tissues that “knit” the tendon back together. Healing can continue past six weeks and in some severe cases up to a year. Over six months of tendonitis is considered chronic.

The initial treatment to tendonitis is to protect the tendons via bracing and wrapping. The tendon needs to be loosened up to prevent any more tearing and pain. Loosening the tendon is done with stretches and exercise. Loosening the tendon can also be achieved with a topical pain reliever that can penetrate the skin. A topical cream that contains menthol will relieve pain and also dilate the blood vessels relaxing the area. Ice can relieve inflammation, but will constrict the blood vessels and further stiffen the tendon.

Once scar tissue builds up, it is vital to begin breaking down the scar tissue so that the tendon will achieve flexibility and prevent further injuries. This can be achieved through massage and ultrasound. Ultrasound will vibrate the area gently increasing circulation to soften up the car tissue. Surgery is performed in more sever cases, to reattach the tendon to the bone.

Non-steroidal anti-inflammatory medications (NSAIDs) will decrease the swelling, pain and inflammation. Cortisone injections are used for persistent pain. Cortisone is a strong steroid that will quickly reduce pain and. swelling. It is injected directly into the site of the pain such as the shoulder or rotator cuff. Not all tendonitis can be treated with a steroid injection. Achilles tendonitis is hardly ever treated with steroid injections because a possible rupture can occur.

If a bone spur is present, it can be removed via surgery or arthroscopy. IT can be performed as an outpatient procedure. Arthroscopy involves a several small incisions to insert surgical tools including a camera to see inside the joint. Arthroscopy can be performed with a local anesthesia.

Rest is also an important form of treatment. Allowing the tendon to heal will help to eliminate tendonitis. Gradually returning to activity will help the healing process. Returning to physical activity should involve checking the performance of exercise so that it involves the correct form and posture, reducing the risk of recurrence. Stretching after a brief muscle warm up will also enable the healing process and help prevent tendonitis.

Prevention

Prevention of tendonitis is achieved by proper stretching. Stretching will lengthen the tendon connection and prevent unhealthy pulling. Tendonitis should be treated immediately preventing it from becoming chronic. Using splints on the susceptible joints – such as knees, elbows and wrist is an important form or protection.

Regular exercise should be alternated. Performing the same exercise will aggravate tendonitis. It is important for athletes to vary their work outs to decrease the potential for tendonitis.

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