Tendonitis and Tendinosis
What is Tendonitis?
Tendonitis (also called tendinitis) is the irritation or inflammation of the tendons (thick fibrous tissues that attach muscle to bone). “itis” is Latin for inflammation; therefore, the word tendonitis literally translates to the inflamed tendon. Tendonitis can occur in many parts of the body and is known by other names such as “tennis elbow,” “golfer’s elbow,” “pitcher’s shoulder,” or “jumper’s knee.”
Where can you get Tendonitis and Tendonosis?
You have tendons throughout your body, even ones that connect to tiny muscles in the face and throat. However, tendonitis and tendonosis typically happen in areas where there are more significant amounts of movement. The most common types of tendonitis and tendonosis are:
Rotator Cuff Tendonitis & Tendonosis
Tendons surrounding the muscles in your shoulder become inflamed or injured over time through repetitive use, such as sleeping on the same shoulder every night or lifting your arm overhead. It’s often referred to as “swimmer’s shoulder,” “tennis shoulder” or “pitcher’s shoulder.”
Tennis Elbow (Lateral Epicondylitis Tendonitis & Tendonosis)
The tendons on the outside of the elbow that are used to make a fist with your hand become inflamed or injured through repetitive use, such as gripping a tennis racket, raking, painting, weightlifting or knitting.
Golfer’s Elbow (Medial Epicondylitis Tendonitis & Tendonosis)
The tendons on the inside of the elbow that are used to rotate your arm and for flexing your wrist become inflamed or injured through repetitive use, such as golfing, pitching or carpentry.
Bicipital Tendonitis & Tendonosis)
The tendon connecting the upper part of the bicep to the shoulder becomes inflamed or injured over time through the repetitive overhead use of the arm.
Calcific Tendonitis of the Shoulder
Small (1-2 cm) calcium deposits form within the tendons of the rotator cuff. The exact cause is unknown, but thought to be caused by the delayed healing of shoulder tendonitis and increasing age, and is more common in people with diabetes.
Quadriceps Tendonitis & Tendonosis
The tendon connecting your quadriceps to your patella (knee cap) becomes inflamed or injured usually from activities that require a lot of starting and stopping such as football and soccer.
Jumper’s Knee (Patellar Tendonitis & Tendonosis)
The tendon connecting your patella (knee cap) to your tibia (shin bone) becomes inflamed or injured from repetitive jumping, such as experienced in gymnastics, basketball, dancing or volleyball.
Peroneal Tendonitis & Tendonosis
The tendons that connect your peroneal muscles of the lower leg to your bones in your foot become inflamed or injured, usually from repetitive ankle motion, such as running or jumping. You can also be more prone to this if you wear unsupportive footwear over long periods or have high arches.
Posterior Tibial Tendonitis & Tendonosis
The tendons connecting your calf muscle to the bones on the inside of your foot become inflamed or injured, usually from repetitive high-impact use of your feet, such as running, soccer or basketball. If left untreated, over time it will result in a collapsed arch and flat foot.
Achilles Tendonitis & Tendonosis
The tendons connecting your calf muscle to your heel bone become inflamed or injured, usually from repetitive high-impact use of your feet, such as running, soccer or basketball.
De Quervain’s disease (Wrist Tendonitis & Tendonosis)
The tendons in your wrist become inflamed or injured, usually from repetitive use of your wrist such as writing, using a computer or sports where you use your wrist often like tennis.
What is a Tendon?
A tendon is a thick fibrous band of tissues that attach muscles to bones. You can think of them like an elastic band, in that they stretch when you move your joints to accommodate the movement. They also help to absorb some of the shocks from your muscles when they move.
What is the Difference Between Tendonitis and Tendonosis?
The most significant differences between tendonitis and tendonosis are onset, duration, and symptoms:
Tendonosis (also called tendinosis) is a long-lasting, chronic, and recurring condition that happens as a result of repetitive strain or an injury that hasn’t healed properly. Because of the long-term nature of tendonosis, there is rarely any inflammation, redness or swelling as a symptom. Instead, you may have more degenerative changes to the tendon such as abnormal blood vessel growth.
Tendonitis is a sudden, acute, and short-term injury to the tendon. You may experience pain, inflammation, redness and swelling in the area. Tears and damage to the muscle are typically more pronounced.
What Causes Tendonitis and Tendonosis?
Tendonitis typically is caused by a sudden injury to a tendon, usually from blunt force, such as landing a jump the wrong way.
Tendonosis is caused by overuse, repetitive strain, or repeated injuries to the same area. Some other risk factors include:
- Increased age
- Overloading a joint
- Trauma: bumping or hitting against an object
- “Weekend warriors”
- Inflammatory diseases like gout and rheumatoid arthritis
What are the Signs and Symptoms of Tendonitis and Tendonosis?
Tendonitis and tendonosis share many of the same symptoms with the exception that tendonitis is often associated with redness, inflammation and swelling of the injured area, whereas tendonosis is not. Symptoms of both include:
- Tender, painful, or stiff joint
- Pain that gets worse when you move the joint
- Decreased range of motion when you move the joint
- A grating or crackling sensation when you move the joint
- A lump along the tendon
How are Tendonitis and Tendonosis Treated?
Tendonitis and tendonosis can be treated at home and in a clinical setting. To ease the pain of both conditions, and the inflammation and swelling of tendonitis, you can:
- Avoid activities
- Gently massage the affected joint
- Gently stretch the affected joint
- Use anti-inflammatory painkillers such as ibuprofen or acetaminophen to ease the pain
- Apply ice (tendonitis)
Physiotherapy for Tendonitis and Tendonosis
A pt Health physiotherapist will assess your tendonitis or tendonosis and identify underlying causes. Depending on the cause of your tendonitis or tendonosis and the joint affected, physiotherapy can include:
- Functional retraining and activity modifications
- Strengthening and range of motion exercises
- Manual therapy (joint and soft tissue mobilizations)
- Personalized exercise plan
- An assistive device, orthotics, or splinting
- Pain relieving modalities such as
- Therapeutic ultrasound
- Heat and ice therapy
- Electrical stimulation
Can Tendonitis or Tendonosis go Away on Their Own?
Yes, if successfully treated at home, tendonitis can go away on its own. However, if it’s not treated correctly, tendonitis can turn into tendonosis. Without treatment or activity modification, tendonosis which is unlikely to go away on its own.
Can you Prevent Tendonitis and Tendonosis?
If you have increased tendonitis and tendonosis risk (you play sports, or your job involves repetitive movements), speak to your physiotherapist about your specific therapeutic needs. However, you can take steps to avoid tendonitis and tendonosis including:
- Ease into new exercise routines
- Warm up before exercise
- Stretch after exercise
- Wear supportive footwear
- Take regular breaks from repetitive movements
- Practice good posture
- Practice good technique in sport