It can be frustrating when doing daily tasks, like turning a door knob or picking up your coffee mug, become painful due to Tendonitis. We are here to help.
Tendonitis and Tendonosis
Achilles tendinitis, patellar tendinitis, tennis elbow, golfer's elbow, and supraspinatus tendinitis
Tendinosis is when you experience pain and burning in the affected area, decreased strength and flexibility, and pain caused by everyday activities. As it turns out, tendinosis is far more often responsible for these symptoms than tendinitis. It is important for health care practitioners to distinguish between these disorders in order to apply the most appropriate treatment.
Tendinosis is a degeneration of the tendon’s collagen in response to chronic overuse; when overuse is continued without giving the tendon time to heal and rest, such as with repetitive strain injury, tendinosis results. Even tiny movements, such as clicking a mouse, can cause tendinosis, when done repeatedly.
Tendinitis is the inflammation of the tendon and results from micro-tears that happen when the musculotendinous unit is acutely overloaded with a tensile force that is too heavy and/or too sudden. Tendinitis is still a very common diagnosis, though research increasingly documents that what is thought to be tendinitis is usually tendinosis.
Achilles Tendinopathy
Achilles tendinopathy is an over-use injury. It tends to occur as a reaction to an increased demand on the tendon, beyond it’s capabilities.The Achilles tendon lies at the back of your ankle. It is a thick, fibrous tissue that attaches your calf muscle to your heel. The function of the tendon is to transmit the forces of the calf muscle to your foot, allowing you to do movements such as point your toes, run and jump. Those who have recently become more active, such as taking up jogging or a jumping sport, can commonly encounter an Achilles tendinopathy. A change of footwear, particularly to unsupportive flat shoes, can also trigger the condition.
Those with an Achilles Tendinopathy will typically report:
- Pain and stiffness, which may be reduced in the short term with brief gentle movement
- Pain that tends to increase when a load is placed through the tendon after periods of immobility, such as first thing in the morning or stepping out of the car after a long drive.
With perseverance, over time your symptoms should reduce in intensity. It is important to increase your movement with stretches, and build some strength back into your Achilles tendon. Your clinician will guide you through the specific exercises which are often best done little and often throughout the day to avoid provoking your pain too much.
Runners Knee
First, it isn’t just for runners. Also, it isn't really a specific injury. Runner’s knee is a broad term used to describe the pain you feel if you have one of several knee problems. You might hear a doctor call it patellofemoral pain syndrome.
Several things can bring it on:
- Overuse
- A direct hit to the knee
- Your bones aren’t lined up
- Problems with your feet
- Weak or unbalanced thigh muscles
- Chondromalacia patella
The main thing is pain. You might notice it:
- Usually in front of your kneecap, though it could be around or behind it
- When you bend your knee to walk, squat, kneel, run, or even get up from a chair
- Getting worse when you walk downstairs or downhill
- The area around your knee could swell, or you might hear popping or have a grinding feeling in the knee
People heal at different rates. Your recovery time depends on your body and your injury.
Tennis Elbow
Tennis elbow (lateral epicondylitis) is a painful condition that occurs when tendons in your elbow are overloaded, usually by repetitive motions of the wrist and arm. Despite its name, athletes aren't the only people who develop tennis elbow. People whose jobs feature the types of motions that can lead to tennis elbow include plumbers, painters, carpenters and butchers. The pain of tennis elbow occurs primarily where the tendons of your forearm muscles attach to a bony bump on the outside of your elbow. Pain can also spread into your forearm and wrist.
The pain associated with tennis elbow may radiate from the outside of your elbow into your forearm and wrist. Pain and weakness may make it difficult to:
- Shake hands or grip an object
- Turn a doorknob
- Hold a coffee cup
Golfers Elbow
Golfer's elbow is a condition that causes pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow. The pain might spread into your forearm and wrist. Golfer's elbow is similar to tennis elbow, which occurs on the outside of the elbow. It's not limited to golfers. Tennis players and others who repeatedly use their wrists or clench their fingers also can develop golfer's elbow.
Pain and tenderness. Usually felt on the inner side of your elbow, the pain sometimes extends along the inner side of your forearm. Pain typically worsens with certain movements.
- Stiffness. Your elbow may feel stiff, and making a fist might hurt.
- Weakness. You may have weakness in your hands and wrists.
- Numbness or tingling. These sensations might radiate into one or more fingers — usually the ring and little fingers.
The pain of golfer's elbow can come on suddenly or gradually. The pain might worsen with certain movements, such as swinging a golf club.
Besides golf, many activities and occupations can lead to golfer's elbow, including:
- Racket sports. Improper technique with tennis strokes, especially the backhand, can cause injury to the tendon. Excessive use of topspin and using a racket that's too small or heavy also can lead to injury.
- Throwing sports. Improper pitching technique in baseball or softball can be another culprit. Football, archery and javelin throwing also can cause golfer's elbow.
- Weight training. Lifting weights using improper technique, such as curling the wrists during a biceps exercise, can overload the elbow muscles and tendons.
- Forceful, repetitive occupational movements. These occur in fields such as construction, plumbing and carpentry.
To cause golfer's elbow, the activity generally needs to be done for more than an hour a day on many days.
You can take steps to prevent golfer's elbow:
- Strengthen your forearm muscles. Use light weights or squeeze a tennis ball. Even simple exercises can help your muscles absorb the energy of sudden physical stress.
- Fix your form. Whatever your sport, ask an instructor to check your form to avoid overload on muscles.
- Use the right equipment. If you're using older golfing irons, consider upgrading to lighter graphite clubs. If you play tennis, make sure your racket fits you. A racket with a small grip or a heavy head may increase the risk of elbow problems.
- Lift properly. When lifting anything, including free weights, keep your wrist rigid and stable to reduce the force to your elbow.
- Know when to rest. Try not to overuse your elbow. At the first sign of elbow pain, take a break.
The pain of golfer's elbow doesn't have to keep you off the course or away from your favorite activities. Rest and appropriate treatment can get you back into the swing of things.
Supraspinatus
Is a common cause of shoulder pain in athletes whose sports involve throwing and overhead motions. Supraspinatus tendinopathy is a common and disabling condition that becomes more prevalent after middle age and is a common cause of shoulder pain. A predisposing factor is a resistive overuse. The supraspinatus tendon of the rotator cuff is involved and becomes degenerated, most often as a result of repetitive stresses and overloading during sports or occupational activities. The tendon of the supraspinatus commonly impinges as it passes between the acromion and the humeral head. This mechanism is multifactorial. The supraspinatus muscle is of the greatest practical importance in the rotator cuff, it derives its innervation from the suprascapular nerve and stabilizes the shoulder, externally rotates and helps abduct the arm, by initiating the abduction of the humerus on the scapula.
One has to think of supraspinatus tendinopathy when the patient says:
- Pain increases with reaching.
- Pain is felt after frequent repetitive activity at, or above shoulder.
- Patient feels weakness of resisted abduction and forward flexion, especially with pushing and overhead movements.
- Patient has difficulty sleeping at night due to pain, especially when lying on the affected shoulder.
- Patient has difficulties with simple movements, such as brushing hair, putting on a shirt or jacket, or reaching the arm above shoulder height.
- Patient has a limited range of motion in the shoulder.
- Patient had a former shoulder trauma.
- The shoulder may be warm and there may be fullness anterolaterally.
- There is a painful arc between 70° and 120° of moving away from the body.
Treatment is aimed towards helping with the following problems that patients with Supraspinatus Tendinopathy complain of: pain, inflammation, decreased ROM, strength, and functional activity.
