TENDONITIS – WHAT IT IS AND HOW TO GET RID OF IT

 By Rick Morris

Tendonitis is one of the most common sports injuries. Here is how to treat it and prevent it.

WHAT IS TENDONITIS?

Tendonitis is basically an inflammation of a tendon. This is an overuse injury. Repetitive movements such as jumping, running or swinging an object can bring on a bout of tendonitis. One of the more common types of tendonitis is known as “tennis elbow”. The repetitive stresses on a tendon cause micro tears, which results in inflammation and pain. Runners can suffer from tendonitis in the knee, hip, foot, Achilles tendon and in the ankle. Achilles tendonitis is a very common running injury and can become chronic if not properly handled.

Tendonitis can occur in any tendon in the body but usually occurs near joints, which suffer continuous stress. The most commonly affected areas are the knee, wrist, Achilles tendon, shoulder and elbow.

SYMPTOMS

Tendonitis is usually first noticed after exercise or even the following morning. In the early stages pain felt at the beginning of exercise sometimes will disappear after the muscles are warmed up. This is one reason that tendonitis is so common. The athlete feels that they can run or play through the pain in these early stages and the injury becomes more aggravated.

The severity of tendonitis is classified in one of four grades.

Grade 1

There is mild pain felt around the affected tendon. There is little or no swelling and range of motion remains normal. Pain is usually felt only after the activity. Treatment at this level will usually avoid more severe levels.

Grade 2

Moderate pain is felt around the tendon at the beginning of the activity. After a short period of time the pain disappears only to return after the activity. Some swelling may be noticed. Range of motion usually remains normal. The pain is not severe enough to restrict the activity. It is usually easy to run through the pain at this level. Most runners are aware of a problem at this point. Treatment is necessary to avoid more severe injury.

Grade 3

Moderate to severe pain is felt all during the activity. The pain remains after the activity. Swelling is noticeable over the tendon. Pain is becoming severe enough to restrict activity. Range of motion is becoming restricted due to pain. At this level, running is becoming difficult. Treatment and some time away from the activity is now necessary.

Grade 4

Moderate to sever pain is felt during everyday activities. Swelling is seen over and around the affected area. Pain makes the activity impossible. Pain becomes more severe. Range of motion is very limited. Running is not possible at this level. Professional treatment is suggested.

TREATMENT

The first step in treating tendonitis is to stop the activity that caused the injury. If you catch the injury early, at stage 1, a reduction in the activity may be sufficient. If the injury is in grade 2, 3 or 4, you should completely stop the activity.

Cold therapy is the second step of treatment. If you are continuing the activity, be sure to ice the area immediately after exercise. You should apply ice to the area 4 to 5 times a day for 10 to 15 minutes. One good alternative to ice is to use a bag of frozen peas or corn. The bag of vegetables can be refrozen and used over and over again. The cold treatment will decrease inflammation and pain.

After the inflammation and pain has been eliminated you should begin rehabilitation. Gently stretch the affected area 4 to 5 times a day. Keep this up until you have a full pain free range of motion restored.

Once you have restored your full range of motion, you should begin strength training to strengthen the muscles and connective tissue. Use light resistance at first. Increase the resistance if no pain is felt. If you feel pain in the affected area, reduce the resistance.

After you have regained full strength you should start the activity at an easy pace. Build back up to your prior level slowly. If you feel pain at any point, you may be trying to progress too quickly. Back off a bit. A little patience here will pay off in the long run.

PREVENTION

A major contributing factor to the development of tendonitis is lack of flexibility, strength, and muscle imbalance. Be sure to stretch all of your major muscle groups before your activity but after a complete warm up. Pay close attention to the muscles and tendons that you have had prior trouble with.

Perform strength training several times a week. Keeping the muscles strong will prevent future problems. Be sure to keep your muscles in balance. If you work the left side, you should work the right side. If you work the front, you should work the back. This will prevent muscle imbalances from pulling joints and tendons out of their neutral and natural positions.

If you feel pain after your activity, apply cold therapy immediately.

If you apply the above preventative measure you should avoid most future problems. If you do become injured, early recognition and treatment is crucial.