Tendinitis

Tendons are made of connective tissue, and serve to connect muscles and bones with each other. Tendinitis can develop if a tendon is frequently put under excessive strain. Eventually, the tendon may become overstrained and painful.

This is often caused by the repetition of the same motion over time, e.g., when playing tennis or volleyball. The tendons in the area of the shoulders and elbows are frequently irritated. In the legs, tendons in the knee and the Achilles tendon at the back of the lower leg are particularly likely to be affected. 

An irritated tendon should be rested for a while. After this rest period, the tendon must be allowed to gradually adjust to normal strain again. Specific stretching exercises are used for this purpose.

Tendinitis generally becomes more common with age. It particularly affects people involved in sports.

Pain is the most typical symptom of tendinitis. In many cases, the pain also restricts movements. In addition, the affected area also may become hardened or slightly swollen.

The pain often occurs where the tendon connects with the bone. Tendinitis is especially painful when the tendon is stretched, when the attached muscle is tensed, or when pressure is exerted on the irritated tendon directly.

For example, an inflamed or irritated Achilles tendon causes pain when standing on tiptoes. However, pain may also occur at rest.

Excessive mechanical strain on a tendon can lead to minor injuries and reduced blood flow to the area. This causes adhesions (where scarring causes tissue to stick together) and calcification (a build-up of calcium deposits) to develop in the tendon tissue, leading to irritation.

Excessive mechanical strain usually occurs if the same movements are regularly performed over and over again, as is the case with many types of sport. For example, repeatedly swinging the arm to hit a tennis ball or golf ball can gradually lead to irritation of the tendons in the elbow.

Regular intensive running can cause excessive strain on the Achilles tendon. Sports that require a lot of jumping, such as volleyball or basketball, often cause tendon pain in the knees.

However, other hobbies and work-related activities can also cause tendons to become overstrained – for example, frequent use of a computer mouse.

In rare cases, tendinitis can occur as a side-effect of taking medication, such as certain antibiotics.

Risk factors that contribute to the development of tendinitis include:

• foot deformities
• ill-fitting shoes
• diabetes
• joint diseases
• autoimmune disorders that cause the immune system to attack tendon tissue 
• smoking
• overweight 

Tendinitis generally becomes more common with age. It particularly affects people involved in sports.

As an irritated or inflamed tendon is painful, many people will automatically rest the affected area. In this case, the pain usually resolves after a few weeks. However, the problem may recur if the tendon is subjected to excessive strain again at some point.

If the tendon is not rested for a sufficiently long period, the irritated tissue does not have enough time to properly heal. This increases the risk of the tendon becoming partially or completely torn at some point.

In addition to examining the affected area, the doctor will ask the patient about his/her occupation and hobbies to determine whether these could explain why the tendon has become overstrained. If the symptoms are typical and if the tendon has been exposed to excessive strain, this is usually enough for the doctor to diagnose tendinitis.

Sometimes, an ultrasound scan is also used to identify other indicators of tendinitis, such as small calcium deposits in the tendon. X-rays or magnetic resonance imaging (MRI) scans may be used to rule out other reasons for the symptoms.

The first part of the treatment involves protecting the irritated tendon. Wearing a brace or bandages may sometimes be of benefit. The rest period should last between 3 and 6 weeks. After this rest period, the tendon must be allowed to gradually adjust to normal use again.

Other treatments, such as ultrasound therapy, massage, and electrotherapy, are used to promote recovery of the tendon and relieve symptoms. Pain medication may also be used for a limited period.

If the symptoms persist despite treatment with these methods, cortisone injections or surgery may be considered. The surgical procedure involves removing damaged tissue or adhesions.

Further information about treating tendinitis is available on gesundheitsinformation.de.

During everyday life, it is often difficult to protect the arms and legs. However, strain on the affected tendon should be minimized as far as possible. It can be useful and practical in this context to set priorities. For example, it may be possible to put off strenuous activities like cleaning windows, weeding the garden or carrying heavy bags of groceries. Alternatively, family, friends or neighbors could perhaps lend a hand.

It is also important to know exactly which movements are to be avoided. A physiotherapist can help with this by explaining which movements will irritate the tendon and which won’t. Occupational therapy may also be beneficial by explaining how daily work-related activities can be done differently to avoid placing too much strain on the tendon.