Tendons are the fibrous cords that anchor muscle to boneand they are vulnerable, since the force of all muscle contractions is transmitted through them. Tendinitis (or tendonitis) is an inflammation of a tendonthe suffix “itis” means inflammationand is characterized by pain, swelling, warmth and redness.
Tendonitis is the problem behind many common overuse injuriesand it can be deceptive: the pain can be severe when you start exercising, then diminish as you continue, only to return sharply once you’ve stopped. Perhaps the most common form of tendinitis is tennis elbow. In sports and activities that involve running and jumping, tendinitis is most likely to develop in the knee, foot, and the Achilles tendon at the back of the ankles. For cyclists, knees are most vulnerable. Shoulder (rotator cuff ) tendinitis can develop from pitching a ball, swinging a golf club, or swimming.
Symptoms of Tendinitis
- Tenderness, pain, dull ache, stiffness, or mild swelling around a tendon or joint
- Restricted movement
- Crackling or crepitus
- Tendon weakness
What Causes Tendinitis?
Almost all active people eventually suffer some form of tendinitis. Regular exercisers are especially at risk because of the strong forces produced by their well-conditioned muscles. These increase tension on the tendons, which can then rub against bones, ligaments and other tendons, causing irritation that leads to tendinitis.
Even if you are sedentary, you can develop tendinitis from repetitive activities like carrying a briefcase or playing a musical instrument for long hours. Posture problems can also lead to tendinitis, as can sudden physical trauma to the tendon resulting from a fall, for example, or a sharp blow or twist to a joint.
What If You Do Nothing?
Tendinitis usually occurs through repetitive physical stress, so altering or eliminating the activity responsible for it should cause the pain to go away. If you continue with the activity that caused the tendinitis and do nothing to eliminate the problem, the ailment may become chronic.
Home Remedies for Tendinitis
- Stop your activity. At the first signs of tendinitis—pain and swelling—immediately stop the activity that’s causing the pain. This will give the tendon a chance to heal. To eliminate the risk of aggravating the injury, don’t resume your activity at full tilt until the pain is completely gone.
- Reduce inflammation. To quell inflammation and reduce any swelling, ice the injured area 20 minutes a session several times a day for the first 72 hours. After using ice, wrap the area with an elastic bandage. After three days, apply heat—or alternate heat and cold—to increase circulation and speed healing. Hot showers, hot compresses, or a heating pad (at low or medium settings) may be sufficient.
- Relieve pain. Use ibuprofen, naproxen, or aspirin according to label directions for relief of pain and inflammation.
- Begin stretching. When pain diminishes, start doing stretching exercises to restore flexibility.
- Begin strengthening. The stronger your muscles, the less stress placed on your tendons. When pain is gone, use light weights to strengthen the muscle groups around the injured tendon.
- Keep muscles flexible. Stretching and strengthening routines can help prevent tendinitis from developing by keeping the muscles supple and strong.
- Develop proper technique. For nearly every sport and recreational activity, certain tendons are vulnerable. But properly executed movements will do a lot to prevent tendinitis problems from developing. Learn the proper movements for any sport you play regularly.
- Don’t overdo it. Drastically increasing the distance you run or suddenly working out more strenuously or longer than usual can produce muscle fatigue and thus lead to an injury.
- Compensate for musculoskeletal problems. If your feet happen to roll inward (overpronate) as you run, you may develop a form of tendinitis in your knee that’s commonly called runner’s knee. You may need to consult a physical therapist, orthopedist, or other specialist for treatment.
- Counter muscle imbalances. If your calf muscles are very strong from running, but you don’t strengthen the opposing shin muscles, you increase the chances of injuring your Achilles tendon. Strengthen the key muscle groups for your activity.
These microscopic breaks in bone, usually in the foot, shin, or thigh, are another form of overuse injury. Common among long-distance runners, aerobic dancers, and basketball players, the fractures are caused by the repeated impact of running or jumping.
Often the pain is mild at first—a dull ache—occurring during or right after exercise. If you continue the activity, the pain gradually increases, but for the first few weeks such fractures are usually too small to be detected, even by x-ray. Fortunately, the fractures rarely break through the bone, so they don’t require splints or casts to heal, only rest.
Prevent stress fractures by increasing the intensity of your workouts gradually, not dramatically. Try to minimize the impact on your legs: run and jump on soft or resilient surfaces—grass, carpet, mats, or suspended wooden gym floors—rather than concrete. Wear well-cushioned exercise shoes.
Beyond Home Remedies: When To Call Your Doctor
It’s usually wise to consult your doctor if you have symptoms of tendinitis, unless it’s an injury you’ve had before and know how to treat. Your doctor may refer you to a physical therapist. Contact your physician immediately if the injured joint appears to be swollen, discolored, or distorted. Also contact your physician if your symptoms don’t resolve with the self-care measures described above, or if pain and swelling increase despite the measures.
What Your Doctor Will Do
After taking a careful history, your physician may recommend a course of physical therapy and may prescribe medication to reduce inflammation and pain. In addition, you may be advised to use an elastic support wrap or sling to compress and immobilize the affected body part.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media