Tendonitis is an inflammation of the tendon, which is a string-like connective tissue that attaches a muscle to a bone. Tendinitis most commonly occurs when the involved tendon is exposed to mild but prolonged repetitive stress and strain. In addition, one-time but severe strain and trauma can also lead to tendinitis. It can be seen in sports such as gardening, shoveling, carpentry, painting, rubbing, tennis, golf. Factors such as poor posture and starting to do intense sports without being in shape increase the risk of tendinitis. Tendinitis can also occur in rheumatic diseases such as rheumatoid arthritis, gout, psoriasis rheumatism. More rarely, tendinitis may be due to a true microbial inflammation. This type of tendinitis may develop due to a cat or dog bite.
Tendinitis can occur in both young and old people. After the age of 40, the risk increases as the flexibility of the ligaments decreases. Decreased flexibility increases the likelihood of tendon rupture and rupture.
If inflammation occurs in the surrounding sheath along with the tendon, it is called tenosynovitis. Tendinitis and tenosynovitis can coexist. Inflammation in the tendons that move the thumb is called De Quervain’s tenosynovitis .
Tendinosis can be defined as tendon problems in which inflammatory features such as edema are not dominant and wear is prominent in relation to overuse and aging. This expression is mostly encountered in shoulder joint MRI (MR) film reports as “findings compatible with tendinosis in the supraspinatus tendon”.
Where Does Tendinitis Occur?
Tendinitis can develop almost anywhere the muscle attaches to the bone. The root of the thumb, wrist, elbow, shoulder (supraspinatus tendinitis, biceps tendinitis), hip, knee, ankle ( Achilles tendinitis ) are the most commonly affected places.
When starting a new exercise, it should be started with less repetitions and resistance. The intensity is gradually increased over weeks. If there is pain during the exercise, stop and reduce the number of repetitions or strength. Despite the pain, the same movement should not be insisted on. You can switch to an activity that works different muscles.
Pain is felt in and around the tendon. The pain may begin mildly and gradually worsen over time. Sometimes the pain may increase suddenly due to the accumulation of calcium (calcification) in the tendon . In tendonitis, pain is evident with active and compelling movements, that is, with muscle contraction, while pain may be absent or milder when passive movement is performed on the joint. While the tendon can normally slide and move freely, a feeling of friction may occur during movement in tendinitis. There may be swelling and redness in the relevant area. A nodule may form on the tendon. If the problems progress too far, there may be a break in the fibers. In this case, the muscle is pulled to one side, there may be a part of the tendon fiber where the feeling of space is taken.
Diagnosis is made by questioning the complaints (taking a medical history) and physical examination. X-rays may be taken to rule out possible bone problems. If there is calcification in the tendon, it may give symptoms on the X-ray film. Ultrasonography can show tendon inflammation, dynamically it can be determined whether there is an abnormality in movements. MRI (MR) imaging is a successful method in demonstrating soft tissue problems.
Avoiding activities that cause complaints, rest, cold application, wrapping with an elastic bandage are the things that can be done by oneself for treatment at the first stage. Massage may be inconvenient for the first few days in tendonitis. Hot application can increase swelling (cold reduces edema). Pain relievers may be prescribed by the doctor for a short time. If your complaints do not decrease in a week, you can consult a doctor. In case of suspected tendonitis, you can be examined by a physical therapy and rehabilitation specialist. Physical therapy (TENS, ESWT , ultrasound therapy, etc.), splint use, cortisone injection are other treatment options. Recovery may take several weeks or months.