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Tendons are fibrous tissues that connect muscles to bones, and thus they are an integral part of the musculoskeletal system, and they should be in good condition for optimal physical movement.

There are more than 600 muscle-tendon units in our body.  They are strong enough to bear lots of stress and strain. However, in some cases, they give up resulting in injury.

In most instances, the injury will heal itself with the help of physical therapy and does not require the use of medications.

what is tendinitis

What is tendonitis?

Tendonitis or tendinitis are used interchangeably to describe the same condition that is inflammation or injury of tendons. These days medical specialists may prefer the term tendinopathy over these terms.

The most common cause of tendon injury is physical exertion or trauma.

Tendon injuries are present in 50% of cases of all sports injuries.

Tendinitis of upper and lower limbs is most common. Thus one may be diagnosed with Achilles tendon pain, tendonitis wrist, peroneal tendonitis, bicep tendonitis, tendonitis hand, shoulder tendonitis, tendonitis ankle, elbow tendonitis, and so on.

Some people are at higher risk of injuring tendons like older adults, those living with diabetes, gout, arthritis, thyroid disease, and other metabolic disorders.

Certain medications may also make tendons weaker and increase the risk of tendinitis.

Tendonitis Symptoms

Tendonitis symptoms

Acute pain is characteristic of tendinitis. Usually, pain is well localized and can be felt at specific points.

Pain may start abruptly after an injury or some physical activity. In some cases, there may be tendon thickening or formation of nodules. In the case of tendon rupture, there may be a loss of mobility.

In most cases, the diagnosis is not difficult and is based on the history of the patient. In a small number of cases, a doctor may ask for an ultrasound, x-ray, or MRI, and other tests.

How to Treat Tendinitis?

Treatment should start by excluding tendon rupture (which requires surgical repair), and systemic diseases like diabetes and so on.
One may use over-the-counter pain-relieving drugs, but they are not necessary in most cases.

Drug therapy like the use of corticosteroids is reserved for only most severe cases.

Physical therapy is the primary way to treat tendinitis. It involves using exercises, stretching, massage therapy, rest, protection (immobilization), and so on.

In acute tendon trauma, any non-pharmacological therapy must start with PRICE.

- Protection – through temporary immobilization, use of splints, and other supportive devices.

- Rest – so that the body has enough time to revive. It means avoiding extreme physical activities but not bed rest.

- Ice – to reduce inflammation and pain.

- Compression – to overcome swelling.

- Elevation – particularly in the case of lower limbs trauma to reduce edema.

    However, once the acute phase is over, physiotherapy with use of exercise is a better way to recover faster. Exercise helps to increase the range of motion, keep muscles and tendons warm, and improve local blood flow. Exercise can be combined with heat treatment for faster recovery.

    When to use heat or ice?

    Since both heat and ice can be used in the treatment of sprains, strains, or tendinitis, it can become a bit confusing for many.

    As a rule of thumb, ice therapy must be preferred in the early stages of tendinitis; it is especially useful during the first 72 hours. Not only does ice reduce pain sensation, but it also helps control inflammation. 

    Inflammation is our body's way to respond as a defense mechanism. It is necessary for complete recovery.  

    However, in most cases, inflammation reaction can be too severe, thereby causing harm and resulting in a slowdown of the recovery process.

    Ice therapy will not prevent inflammation, but it will help keep it in control.

    For ice therapy, one can use a gel ice pack, or even a pack of frozen vegetables like a bag of peas would work well.

    Apply an ice pack for about 15 minutes several times a day. In clinics, the specialist may use cryotherapy with the help of a particular apparatus.

    Once that early phase is over and pain has subsided. It is time to start physical therapy, start moving, start doing exercises, stretching. However, before beginning physical therapy, it is advisable to use heat treatment to increase local blood flow and relax surrounding muscles.

    The heat treatment can be continued for many days, even when pain and visible inflammation has subsided. Heat will help in better healing.

    For heat therapy, one can use special electric pads, hot water bottle, even saunas, or infrared lamps. Hot baths, steamed towels may also help.