Description:

Tendons are bands of strong connective tissue that attach muscle to bone. Tendonitis is inflammation of a tendon. The symptoms include pain and swelling. Tendonitis is usually a type of overuse injury; the tendon is repeatedly strained until tiny tears form. Sites that are prone to tendonitis include the shoulder, wrist, knee, shin and heel. Most cases of tendonitis will settle spontaneously.

Cause:

Some of the common causes of tendonitis can include:

  • Overuse of the tendons by repetitive actions.
  • Calcium deposit along the tendon at the site of insertion.
  • Bone spurs on the heels.
  • Any sporting activity that requires lots of jumping and running.
  • Running on hard surfaces.
  • Poor sporting technique, such as holding a tennis racquet or golf club incorrectly.
  • Inappropriate sporting equipment, such as a tennis racquet that’s too heavy.
  • Lifting weights that are too heavy.
  • Lifting heavy weights without warming up properly.
  • Neglecting to warm up properly prior to sport or exercise.
  • Extreme and regular physical effort, such as an intensive sports training schedule.
  • Not taking enough time between training sessions to allow full recovery.
  • Exercising in cold temperatures.
  • Awkward positions that are maintained for a long time.
  • Being obese, which puts excessive pressure on the tendons of the legs.

Symptoms

The symptoms of tendonitis can include:

  • Pain
  • Swelling
  • Stiffness and restricted mobility at the affected joint
  • Muscle weakness
  • The skin over the affected area may feel warm to the touch.

The symptoms of tendonitis can be similar to those of other conditions, such as arthritis or infection, so it is important to seek medical advice if your symptoms don’t improve despite home care.

Pathophysiology

Tendons transmit the forces of muscle to the skeleton. As such, they are subjected to repeated mechanical loads, which are felt to be a major causative factor in the development of tendinopathy. Pathologic findings include tendon inflammation, mucoid degeneration, and fibrinoid necrosis in tendons. Microtearing and proliferation of fibroblasts have also been reported. However, the exact pathogenesis of tendinopathy is unclear.

Diagnosis

Tendinitis, also called overuse tendinopathy, typically is diagnosed by a physical exam alone. If you have the symptoms of overuse tendinopathy, your doctor may order an ultrasound or MRI scans to help determine tendon thickening, dislocations and tears, but these are usually unnecessary for newly diagnosed cases. Your doctor can also assess whether you have similar problems such as bursitis (inflammation of the fluid “cushion” surrounding the joints).

Orthotics

Orthotic devices or shoe inserts are used to control the excess motion that strains the plantar fascia ligament and/or Achilles tendon. In most cases, orthotics can reduce stress on the Achilles tendon to relieve tendonitis at the back of the heel. Similarly, sports running shoes which are stable with soft, cushioned soles can be helpful in reducing irritation of inflamed tissues.

Severe or persistent tendonitis should be investigated by your doctor. You may need professional medical care that includes prescription drugs, or else your symptoms may be caused by conditions other than tendonitis. For example, you may be suffering from arthritis, bursitis, infection or a fracture. Generally speaking, if your symptoms haven’t improved after one or two weeks of home treatment, or if the pain is severe or debilitating, see your doctor. Most cases of tendonitis recover completely without the need for any medical input; however, uncommonly, severe untreated tendonitis can lead to rupture of the tendon.

Heel Tendonitis

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