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What Is Tendinitis And Its Cause

May 31, 2008
Tendons themselves are cords of tough, fibrous connective tissue that attach muscles to bones. Tendinitis is an inflammation of the tendon. The condition may also involve the tendon sheath, usually close to where the tendon goes into the muscle.

Tendons are generally healthy structures that appear glistening white to the naked eye. If you've ever carved a turkey, the tendons are the tough bands you cut through to get the drumsticks apart.

The most common cause of tendinitis is overuse and repetitive motion from recreational, athletic, or occupational activities.

These are some of the more common forms of tendinitis. Medial epicondylitis (also known as golfers elbow, baseball elbow, suitcase elbow) is caused by forceful wrist flexion and pronation injuring the tendons that attach to the medial epicondyle of the humerus. Lateral epicondylitis (tennis elbow) is caused by continued stress on grasping muscles of the hand on rotation so the forearm faces upward or forward

Rotator cuff tendinitis (swimmer's shoulder, tennis shoulder, pitcher's shoulder) - Caused by sports that require movement of the arm over the head repeatedly causing inflammation on the rotator cuff a group of muscles that control shoulder rotation. Peripatellar tendinitis (jumper's knee) - Caused by repetitive jumping, running, or cutting.

Popliteus tendinitis is caused by downhill running or walking. Achilles tendinitis is caused by downhill running. Trauma or thermal injury to the tendon. Evidence of a strong association between the fluoroquinolone antibiotics and tendinitis

Tendinitis causes pain over the affected tendon close to where it is inserted into the muscle. The pain is usually worsened with repetitive motion, but it can also be present at rest. There can also be mild swelling over the tendon.

Medial epicondylitis causes pain in the flexor pronator tendons and medial aspect of elbow when the wrist is flexed or rotated outward against resistance. Lateral epicondylitis - Pain in the lateral epicondyle of the elbow when the wrist is extended against resistance. Rotator cuff tendinitis - Pain initially when the arm is brought forward over the head, severe pain when bringing the arm across the chest.

Peripatellar tendinitis causes pain in the region of the kneecap during or after physical activity. Popliteus tendinitis causes pain in the side of the knee with downhill running. Achilles tendinitis, the pain with dorsiflexion of foot usually while running

If you have symptoms of tendinitis, see your doctor to rule out other causes of pain such as a torn tendon, infectious versus degenerative arthritis, bursitis, infectious tenosynovitis. Go to an emergency department for evaluation if you experience fever, increased redness, or worsening symptoms without relief with treatment at home.

To help yourself at home, we suggest you rest, immobilization of affected extremity, ice to affected area, elevation of affected extremity, and use over-the-counter nonsteroidal anti-inflammatory medications (such as Advil or Aleve).

Recommendations, Ice the affected area 20 minutes at a time every several hours for at least the first 24-48 hours. Wrap ice in a towel to protect your skin. Change to heat treatments for the next several days. Elevate and immobilize the affected extremity. Use slings and splints to keep the injured area of shoulders and arms from moving.

For other parts of the body, use compression with Ace bandages to reduce swelling. Crutches may be helpful. Begin an exercise program to build muscle strength and range of motion with a physical therapist after the acute phase.

The doctor may recommend pain control with nonsteroidal anti-inflammatory drugs you can buy over-the-counter, such as ibuprofen (Motrin, Advil). If pain is severe, the doctor may give you an injection with steroids. This may help by decreasing pain and inflammation but should not be done more than a few times because steroids weaken the tendon, leaving it vulnerable to rupture (see ruptured tendon).

Furthermore, Extracorporeal shock wave therapy has been shown to have good results in calcific tendinitis or other forms of tendinitis. Currently, it is still being studied. Also, ultrasound therapy is used in some cases, but its effect has not been proven. Its greatest usefulness may be in calcific tendinitis.

Diagnosis is usually made based on the way the affected tendon and movement of the associated muscle feels. The doctor may have you do these movements to check for pain and tenderness. Medial epicondylitis: The forearm is placed in supine position, and the fist is flexed against resistance while the forearm is held down.

Tenderness is felt in the area of the medial epicondyle and flexor pronator tendons. Lateral epicondylitis: The forearm is placed in prone position on the table, while the forearm is held in place. You try to extend your wrist against resistance. Tenderness is felt along extensor area.

Rotator cuff tendinitis; Supraspinatus: Bend the arm to 90 and place it forward 30 with the thumb pointed down. Pain or weakness against resistance can be felt if there is involvement of this tendon. Infraspinatus and teres minor: With your arm against your body with elbow bent at 90, the doctor will stabilize the elbow against your waist and have you externally rotate against resistance, which will bring on pain if these tendons are involved.

Subscapularis: With your arm against your body and the elbow bent at 90, while stabilizing the elbow, the doctor will have you internally rotate your arm inward around the front of your body against resistance, which will cause pain if this tendon is involved.

Peripatellar tendinitis; Tenderness can be felt over the quadriceps tendon at the upper part of the kneecap. Popliteus tendinitis: Sit with the side of your injured heel resting on the knee of the opposite leg.

Tenderness can be felt just in front of the fibular collateral ligament. Achilles tendinitis: Tenderness is felt when the Achilles tendon is squeezed between the fingers. Ultrasound evaluation of the tendon with real time machines can give an accurate diagnosis. A CT scan and MRI can be used. The MRI is better able to identify tears, partial tears, inflammation, or a tumor.
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