A tendon is a flexible band of fibrous tissue located in the body where muscles and bones connect. They are responsible for muscle contraction and the ability to move your bones. Tendinitis is a condition where tendons are inflamed, severely swollen and/or damaged. Tendinitis is usually caused by repetitive overuse of a tendon from performing activities such as swimming, painting, raking or playing the guitar. Other causes are age-related changes, diseases (arthritis and diabetes), high blood cholesterol levels and anatomical causes (poorly placed bone or joint).
Common Types
The most common places for tendinitis to occur are the elbow, shoulder, knee, hip, Achilles tendon and the base of your thumb. Tennis elbow affects the outer tendon, while golfer's elbow affects the inner tendon of the elbow. Shoulder tendinitis includes bicep and rotator cuff injuries. Knee tendinitis is also called "jumper's knee" due to overuse of the knee when jumping, bicycling, dancing and more. The Achilles Tendon is the largest tendon of the body. It connects the calf muscle to the heel. This form of tendinitis is common in athletes who spend many hours stressing this large tendon.
Treatment
Tendinitis needs to be diagnosed by a doctor or physical therapist through a physical examination. The initial treatment of tendinitis is to rest the injured area and avoid any activities and repetitive movements that aggravate the area. Other initial treatments include icing the area soon after the injury, the use of splints and straps to protect the affected area and taking over-the-counter anti-inflammatory medicines such as aspirin, naproxen and ibuprofen. If after a week, your tendinitis does not improve, you need to consult your doctor, who may recommend Corticosteroid injections directly into the affected area, physical therapy and in rare cases, surgery.
Stretching/Strengthening/Massage
One of the most common forms of physical therapy your therapist will have you perform will include stretching your joints and muscles around your tendinitis in a gradual series of sessions to improve range of motion and flexibility. Also, gentle strengthening exercises will be performed to improve the function of your muscles and to help heal your tendinitis. Your physical therapist will assign you an exercise program catered to your condition and limitations. Core strengthening of the foundation of your body (back and pelvis), especially in the form of Pilates, helps tendinitis of many forms. Massage of soft tissue is also used to aid healing.
Hot and Cold Therapies
Your physical therapist may also apply cool and warm temperatures to your injured area, which helps decrease swelling and stimulate blood flow. Your physical therapist may apply a compress, pack and/or gels directly onto your skin. An ice pack may also be used in less severe injuries and should not be placed on the skin for longer than 15 to 20 minutes, every four to six hours for three to five days. Other physical therapy treatments include hydrotherapy (use of water). Your physical therapist may have you soak your affected areas in certain temperatures in a whirlpool, hot tub or pool, along with doing some water aerobics.
Ultrasound and Electrical Stimulation
Ultrasound is a form of physical therapy that helps heal tendons by using high-frequency sound waves to relax muscles and ligaments. It also increases blood flow, reducing swelling and inflammation. Physical therapists usually use a hand-held ultrasound devise and apply it over the skin of the affected area, where the waves can penetrate up to two inches for targeted treatment. Electrical stimulation therapy involves an electrical current passing through skin to the affected area to help reduce pain. Electrical stimulation helps to alter nerve conduction and thus helps muscle contractility, as well as increasing blood flow to the tendons.
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