Tendonitis

by Dr. Jason Barker August 16, 2010

Tendonitis

Tendonitis is a painful inflammatory condition located in or around a tendon. Tendons are specialized bands of connective tissue that serve as attachments for muscles to bones. One of the most ‘famous’ (maybe more properly stated as ‘notorious’) tendons is the Achilles tendon. The Achilles is that huge tendon (the largest one in your body, as a matter of fact) on the back of your ankle.

Tendons get their own name for their own condition because they are so prone to it.  If you’re an athlete, chances are you’ve had tendonitis. 

A condition that is relatively easy to come by, overuse and or repetitive motion are always the cause. But more on that later….

Tendonitis tends to affect the larger, harder working tendons. Think about what they do – the entire force that is placed on a muscle gets transferred through the tendon as the muscle pulls on the bone moving the limb. The Achilles tendon takes the entire weight of your body during the push off phase of running and walking. That’s a lot of force, regardless of how much you weigh. 

It doesn’t have to be a tendon that bears a lot of weight, either.  Moms get their own special type, called ‘mother’s wrist’ from picking up and holding their little bundles of joy with their wrists bent (all day long..)  Tennis elbow and golfer’s elbow are names for two very common types of tendonitis. Tennis elbow occurs on the outside of the elbow-also known as lateral epicondylitis and golfers get it on the inside of the elbow-also known as medial epicondylitis.

Now that we have that clear, just what IS tendonitis?  It means quite literally, inflammation of the tendon. Tendons become inflamed from overuse, also known as repetitive motion injury. You know, doing the same thing over and over and over…like running, or swinging a bat, etc. 

Tendons have a poor blood supply in general. Because of this, the body is challenged to deliver adequate nutrition to the tendons when they are damaged, and this leaves them susceptible to injury. In addition, tendons loose their elasticity as we age, making them more easily injured. 

Symptoms include burning-type pain, tenderness, swelling and weakness. 

Having this condition almost always means that an athlete needs to stop and rest (we know, rest is a four-letter word to most athletes…!) so the tendon can heal and the inflammation subsides. 

What happens when one doesn’t rest and let the inflammation go away? We know have a chronic condition known as Tendinosis, which is a relatively permanent state of disrepair and degeneration. Tendinosis has ended many professional and amateur sporting careers, mark our words! At this point, the normal architecture of the tendon is replaced with disorganized connective tissue – now the tendon cannot perform properly and stays in a constant state of inflammation. Therefore, it’s really a good idea to treat any kind of tendon pain as soon as you feel it coming on. 

So how do you treat it?

We recommend a few different things:

  • Ice. You should ice the inflamed area three times daily.
  • High-dose enzymes. Enzymes help decrease the inflammation and assist with the repair process. These should be used in place of ibuprofen or other NSAID drugs. NSAIDS, while great at taking the pain away, will inhibit proper healing of the damaged tendon.
  • Essential fatty acids ( fish oil). Similarly, fish oil contains molecules that stop the production of pain- and inflammation-generating chemicals in the body. 
  • Some type of physical therapy, such as Active Release Technique or Graston Technique.  Many different types of healthcare practitioners are schooled in these and other soft-tissue therapies. 

In fact, we recommend that ALL athletes maintain an aggressive anti-inflammatory supplement program for the very reasons we listed above – tendonitis will sideline you for several weeks, and tendinosis may keep you out of your game permanently. 

Dr. Jason Barker
Dr. Jason Barker


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