The tough, flexible bands of fibrous tissue throughout the body that attach muscles to bones are tendons. In sports, they can easily become irritated or inflamed from the stress of repeated movements, or an acute injury such as a missed step or impacts from falls and collisions.
What Is Tendonitis?
Also spelled tendinitis, tendonitis refers to an inflammation of the tendons because it is irritated and inflamed. The suffix, -itis, means inflammation. Tendinitis can cause deep, nagging pain that limits easy, comfortable movements.
The most common cause of tendonitis in athletes is an acute injury that forces a tendon to stretch beyond its normal range of motion and causes pain, swelling, and inflammation.
What Is Tendinopathy?
Physicians use the term tendinopathy to describe many tendon injuries, such as tennis elbow, golfer’s elbow, Achilles tendon injuries, etc. Experts now recognize that typical tendon injuries are more often caused by long-term overuse that results in a deterioration of the tendon without any associated inflammation.
The Difference Between the Two
The distinction between the two conditions is important because the inflammation of tendinitis is treated differently than the deterioration of tendinopathy (tendinosis). Inflammation from acute tendonitis often responds quickly to medications and anti-inflammatory treatment. However, if the injury is due to tendon tissue degeneration, treatment may be quite lengthy and will be focused on improving the strength of the tendon and rebuilding tissues.
Sometimes tendinitis or tendinopathy can develop due to improper sports technique or biomechanical issues, in which case working with a coach or trainer is the best way to prevent a chronic problem from developing. Making sure to perform a proper warm-up and including enough cross-training is also helpful to prevent tendon overuse injuries.
Overuse injuries are the result of repetitive use, stress, and trauma to the soft tissues of the body (muscles, tendons, bones, and joints) without proper time for healing. They are sometimes called cumulative trauma, or repetitive stress injuries.
If you have a sudden ache or pain in a tendon, and tendonitis is suspected the first thing to do is to stop activity and rest. Tendonitis will respond to the R.I.C.E. method (rest, ice, compression, and elevation). This method helps decrease inflammation and swelling and bring temporary pain relief. This type of conservative treatment is generally all that is necessary to recover from true tendonitis. Tendinitis usually resolves in a few days to a few weeks.
Unfortunately, it may take from two to six months to heal from long-term tendinopathy. Many tendon injuries turn into chronic problems that gradually get worse because the athlete continues activity despite the nagging pain.
If your tendon pain lasts more than a few days despite rest and conservative treatment, you should see a sports medicine specialist for an evaluation and work with a physical therapist to rehab the tendon.
Physical therapists may use ultrasound or other modalities to help heal tendinopathy. In some cases, splints or braces may be used to take the pressure off the tendon as it heals. Common methods of rehab include ultrasound, medications, massage, bracing or splinting.
The final stage of rehab for tendinopathy includes strengthening and flexibility exercises. Your PT will help determine the best rehab path for you, but it’s important to understand that beginning any exercises before the tendon has healed may make the problem worse, so it’s essential to follow your therapist or physician’s recommendations.
If you can determine the cause of the tendon injury and make a correction, you can often avoid long-term problems. If your pain is from overuse, reduce or stop that activity and find a substitute activity. If the pain is from poor technique or poor ergonomics, consult a coach or trainer for skills training. If you can eliminate the offending factors, you have a much greater likelihood of a full recovery.
To prevent the return of tendon overuse injuries, athletes should maintain a training schedule that includes varied intensity and duration as well as the type of activity.
Some areas of the body that commonly develop tendon injuries include:
- Tennis Elbow (Lateral Epicondylitis)
- Golfer’s Elbow (Medial Epicondylitis)
- Achilles Tendinitis
- Wrist Tendinitis
- Carpal Tunnel Syndrome