Tendonitis and tendinopathy are terms commonly used to describe problems with the tendons. Tendons are strong connective tissues that attach muscles to bones.
What is Tendonitis and Tendinopathy?
Tendonitis occurs when a tendon becomes irritated and/or inflamed, causing pain and swelling. Tendonitis is often characterised by overuse or repetitive strain injuries to a tendon without adequate time for healing.
On the other hand, tendinopathy is a broader term that encompasses various tendon problems, including tendonitis. Tendinopathy refers to any issue with a tendon, which may also include tendinosis, tendon tears, and inflammation of the surrounding membranes. Tendinosis is a condition where the tendon develops degenerative changes due to ongoing chronic tendonitis or repetitive strain injuries without sufficient healing time.
Causes and Risk Factors of Tendonitis and Tendinopathy
Tendonitis and tendinopathy are most commonly caused by overuse or repetitive strain injuries to the tendons. These injuries occur when a tendon is repeatedly strained until tiny tears form. This often happens due to activities or movements that involve repetitive motions without adequate rest or recovery time.
Certain risk factors can increase the likelihood of developing tendonitis or tendinopathy.
These include participating in sports or activities that involve repetitive movements, improper technique or form while exercising, poor conditioning or muscle imbalances, aging, and certain medical conditions such as rheumatoid arthritis or diabetes.
It is important to differentiate between tendonitis and tendinosis, as tendinosis often gets misdiagnosed as tendonitis. Proper diagnosis and treatment are crucial for managing these conditions effectively and preventing further damage to the tendons.
Common Types of Tendonitis and Tendinopathy
Achilles Tendonitis and Tendinopathy
One common type of tendonitis and tendinopathy is Achilles tendonitis. The Achilles tendon is located at the back of the lower leg and connects the calf muscles to the heel bone. Achilles tendonitis is often caused by overuse or repetitive strain on the tendon, such as excessive running or jumping activities. It is characterised by pain and inflammation in the area above the heel.
Another type of Achilles tendinopathy is called insertional Achilles tendinopathy, which affects the area where the tendon attaches to the heel bone. This condition can also be caused by overuse or repetitive strain, but it may also be associated with degenerative changes in the tendon.
Tennis Elbow and Golfer’s Elbow
Tennis elbow, also known as lateral epicondylitis, refers to the irritation of the tendons on the outside of the elbow. It is commonly caused by repetitive gripping and wrist extension motions, often seen in activities like tennis or using tools. Golfer’s elbow, also known as medial epicondylitis, is similar but affects the tendons on the inside of the elbow. It is caused by repetitive gripping and wrist flexion motions, commonly seen in activities like golf or weightlifting.
Both tennis elbow and golfer’s elbow can cause pain, inflammation, and tenderness in the affected area. These conditions are prevalent not only among athletes but also among individuals who engage in repetitive gripping motions or have poor technique or form.
It is important to seek proper diagnosis and treatment for tendonitis and tendinopathy to manage symptoms effectively and prevent further damage to the tendons. Physical therapy, rest, activity modification, and in severe cases, surgery may be recommended to alleviate pain and promote healing.
DeQuervain’s tenosynovitis
De Quervain’s tenosynovitis is a painful condition that affects the tendons on the thumb side of the wrist. It is caused by inflammation of the tendons and their protective sheath, leading to pain, swelling, and difficulty moving the thumb and wrist. This condition is often associated with repetitive hand and wrist movements, such as in activities like texting, typing, and lifting.
Trigger finger or trigger thumb
Trigger finger or trigger thumb is a condition in which the finger or thumb gets stuck in a bent position, and then straightens with a snap, like a trigger being released. This is usually caused by inflammation or narrowing of the sheath that surrounds the tendon in the affected finger or thumb. It can cause pain, stiffness, and difficulty moving the affected digit. Treatment may include rest, splinting, medication, or in severe cases, surgery.
Symptoms and Diagnosis of Tendonitis and Tendinopathy
Recognising the Signs of Tendonitis and Tendinopathy
Tendonitis and tendinopathy can cause a range of symptoms that can vary depending on the affected tendon. However, there are some common signs to watch out for. These include pain, swelling, stiffness, and restricted mobility at the affected joint. Muscle weakness is also a possible symptom of these conditions. In some cases, the skin over the affected area may feel warm to the touch. It is important to recognise these symptoms as early as possible to seek appropriate medical attention and prevent further damage to the tendons.
Diagnostic Methods for Tendonitis and Tendinopathy
To diagnose tendonitis and tendinopathy, a doctor may start by taking a detailed medical history and conducting a physical examination of the affected area. They may ask about how the injury occurred and any specific activities that may have contributed to the condition.
In some cases, imaging techniques such as x-rays, ultrasound, or MRI may be used to visualise the affected tendon and assess the extent of the damage. These imaging tests can help confirm the diagnosis and rule out other possible causes of pain and inflammation.
It is important to note that in most cases, a diagnosis of tendonitis can be made based on the clinical assessment, and imaging tests are not always necessary. However, in certain situations where the diagnosis is unclear or if there is suspicion of more severe damage, these imaging techniques can provide valuable information to guide treatment decisions.
Medications and Injections for Tendonitis and Tendinopathy
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve pain and reduce inflammation in patients with tendonitis and tendinopathy. These medications work by blocking the production of certain chemicals in the body that contribute to pain and inflammation.
NSAIDs can be administered topically or orally. Topical NSAIDs, such as creams and gels, are applied directly to the skin over the affected area and are generally effective for relieving localised pain. Oral NSAIDs, such as ibuprofen and naproxen, are taken by mouth and provide systemic relief for more widespread pain and inflammation.
It is important to note that while NSAIDs can provide temporary relief from symptoms, they do not address the underlying cause of tendonitis or tendinopathy. Therefore, they should be used in conjunction with other treatment modalities to promote long-term healing and recovery. It is also essential to follow the recommended dosage and duration of NSAID use to minimise the risk of potential side effects, such as gastrointestinal irritation and increased bleeding.
Corticosteroid Injections and their Effectiveness
Corticosteroid injections have been a mainstay in the treatment of tendonitis and tendinopathy. These injections deliver powerful anti-inflammatory medications directly to the affected area, providing rapid relief from pain and inflammation.
However, the effectiveness and safety of corticosteroid injections in this setting have been subjects of controversy. Several controlled trials and systematic reviews have shown mixed results regarding their efficacy. One study found that corticosteroid injections were not substantially different in effectiveness when compared to physiotherapy, although another study reported short-term greater overall improvement with corticosteroids.
While corticosteroid injections can provide significant short-term relief, there are concerns about their long-term effects on tendon healing and potential side effects, such as tendon degeneration and rupture. Therefore, these injections should be used judiciously and under the guidance of a healthcare professional.
Myotherapy for Tendonitis and Tendinopathy
If you’re struggling with tendonitis or tendinopathy, you know just how debilitating and frustrating these conditions can be. The good news is that myotherapy offers a promising alternative (or complimentary) for relieving pain and promoting healing.
Myotherapy is a specialised form of manual therapy that focuses on treating and managing musculoskeletal conditions, including tendonitis and tendinopathy. Myotherapists are trained to thoroughly assess these conditions and develop individualised treatment plans to address the root cause of the issue.
One of the key aspects of myotherapy for tendonitis and tendinopathy is the emphasis on strength and rehabilitation. Myotherapists provide knowledge on corrective exercises that can help improve strength, flexibility, and range of motion in the affected area. These exercises are tailored to your specific needs and are essential for promoting long-term healing and preventing future flare-ups.
In addition to corrective exercises, myotherapy may also incorporate other passive treatments such as massage and stretching. However, it is important to note that certain stretching techniques may not be suitable for tendon pathologies and should be avoided.
Furthermore, myotherapy may complement other treatment modalities such as NSAIDs (nonsteroidal anti-inflammatory drugs), injections, or shock wave therapy. By combining these various approaches, myotherapy aims to provide a comprehensive treatment plan that addresses pain relief, inflammation reduction, and the overall healing of the tendon.
If you’re tired of living with the pain and limitations of tendonitis or tendinopathy, it may be time to consider myotherapy as a part of your treatment plan. Consult with a qualified myotherapist who can assess your condition and develop a personalised approach to help you regain normal function and movement. With the right guidance and treatment, you can overcome these tendon issues and get back to living a pain-free life.
Conclusion
In conclusion, NSAIDs and corticosteroid injections are commonly used treatments for tendonitis and tendinopathy. NSAIDs can provide temporary relief from pain and inflammation, while corticosteroid injections can offer more rapid and significant short-term relief.
However, the long-term effectiveness and safety of corticosteroid injections are still under debate.
It is essential to consult with a healthcare professional to determine the most appropriate treatment approach based on individual needs and circumstances.
At Surf and Sports Myotherapy, we strongly believe that Myotherapy can be complimentary to medication or injection and we’ll be very happy to discuss this in details with you.