The Painful Truth about Tendonitis

Tendinitis (also called tendonitis) is an inflammation or irritation of a tendon, a thick cord that attaches bone to muscle.  Tendons are tough, flexible, fibrous bands of tissue that connect muscles to bones. When tendons become inflamed, irritated or suffer microscopic tears, the condition is called tendonitis. Tendons can be small, like the delicate, tiny bands in the hands, or large, like the heavy, ropelike cords that anchor the calf or thigh muscles.

What Causes Tendinitis?

In most cases, the cause of tendonitis is unknown; when a cause can be identified, the condition usually happens for one of two reasons:
1) Overuse – A particular body motion is repeated too often.  Think basic repetitive movements like painting, tennis, golf, playing instruments, gardening, etc.
Overload – The level of a certain activity, such as weightlifting, is increased too quickly.
Incorrect posture at work or home, poor stretching or conditioning before exercise also increases a person’s risk.  Unless you’re doing Pilates, then you don’t have to worry about this added risk!

Other risk factors for tendinitis, include:

  • Overuse or doing too much too soon when the tendons are not used to a movement or to the task taken on. Tendinitis is common in “weekend warriors,” people that play and exercise hard only on weekends.
  • Stresses from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, or unusual medication reactions.
  • Occasionally an infection can cause tendinitis, especially infection from a cat or dog bite to the hand or a finger.
  • An abnormal or poorly placed bone or joint (such as length differences in your legs or arthritis in a joint) that stresses soft-tissue structures.
So, now that we know how we get tendinitis, we should also know that anyone over 40 is at added risk.  As tendons age they tolerate less stress, are less elastic, and are easier to tear.  The benefits to aging keep getting better and better, don’t they?

Where Does Tendinitis Occur?

Tendinitis can occur in almost any area of the body where a tendon connects a bone to a muscle! The most common places are:
  • Base of the thumb
  • Elbow
  • Shoulder
  • Hip
  • Knee
  • Achilles tendon
How Can You Avoid Tendinitis?
To avoid tendinitis, try these tips when performing activities:
  • Take it slow at first. Gradually build up your activity level.  “No pain, no gain” are not the words to live by.
  • If you’re a runner or participate in a sport with lots of running, be sure to wear shoes that fit properly.  There are stores that will fit you properly for a sneaker.
  • If you participate in racquet sports, changing to a racquet with a larger head may help to prevent injury as long as the new racquet is not heavier than the original.
  • Avoid activities that require prolonged periods of reaching over your head, such as painting the ceiling. If you must do this kind of work, take frequent breaks.
  • Use a coach to ensure your technique is proper.  Good thing for you that REV is staffed with talented instructors with an eye for detail.  No bad form in our classes!
Pilates can actually help in tendonitis prevention.  Because Pilates strengthens the intrinsic muscles (deep and close to the joint), you are less apt to overtrain or tear your tendons. Pilates also helps restore full range of motion – and flexibly equals pliability. The more pliable the tendons are, the less likely they are to become inflamed.
Unfortunately, if you lead an active lifestyle, you are fairly likely to encounter tendinitis at some point in your life.  You might have tendonitis if there is sudden and chronic pain at a joint you use for repeated movements, i.e. your elbow hurts every day all of a sudden and you play tennis.  Some people experience “frozen shoulder” or loss of motion at a joint.

How Is Tendinitis Treated?

Initial treatment of tendinitis includes rest, ice and taking over-the-counter anti-inflammatory drugs or using topical anti-inflammatory gels.

If the condition does not improve in a week, see your doctor.

How Long Will Recovery From Tendinitis Take?

Tendinitis may take weeks to months to go away, depending on the severity of your injury.  Personally, I’ve suffered from tendonitis in various places and it usually takes several months, if not longer to heal completely.   For example, wrists and shoulders are difficult to rest, so the annoying pain persists!  I suggest rest, ice, repeat!

**For those of you who may be concerned that you are suffering from tendinitis, you might benefit from the following content.  It’s an excerpt from a medical website about tendonitis at specific joints, the symptoms, expectations, etc.

Tendonitis in the shoulder – The most common form of tendonitis in the shoulder is rotator cuff tendonitis. It involves the tendon of the supraspinatus muscle, which attaches to the upper portion of the upper arm bone (humerus) at the shoulder joint. Less commonly, the tendon of the infraspinatus muscle or other tendons of the rotator cuff is affected. In most cases, the supraspinatus tendon is injured by overuse, typically in an occupation or sport that requires the arm to be elevated repeatedly. People at risk include carpenters, painters, welders, swimmers, tennis players and baseball players. The average patient is a male laborer older than 40, and the shoulder pain is on the same side as his dominant hand (for example, right shoulder pain in a right-handed person).

*Usually dull, aching shoulder pain that can’t be tied to one location. It often radiates into the upper arm toward the chest. The pain is often worse at night and may interfere with sleep.
Tendonitis in the elbow – Two forms of tendonitis commonly involve the elbow: lateral epicondylitis and medial epicondylitis. Both are very common overuse injuries among athletes involved in throwing and racquet sports.
Lateral epicondylitis (tennis elbow) causes pain on the outer side of the elbow joint. This condition probably affects 40% to 50% of all adult athletes who play racquet sports. It also can be caused by any activity that repeatedly twists and flexes the wrist, such as pulling weeds, using a screwdriver or even carrying a briefcase.
* Pain in the outer side of the elbow. In some cases, the painful area extends down to the forearm and wrist.
Medial epicondylitis (golfer’s elbow) causes pain on the inner side of the elbow. It is a less common injury than tennis elbow and, despite its name, it is more likely to be related an occupation that requires repeated elbow movements (such as construction work) than to sports. When it does occur as a sports injury, medial epicondylitis can be triggered by repeatedly swinging a golf club or throwing a baseball.
* Pain in the inner side of the elbow.
Tendonitis in the knee – Jumper’s knee, the most common form of knee tendonitis, involves either the patellar tendon at the lower edge of the kneecap or the quadriceps tendon at the upper edge of the kneecap. It is a common overuse injury, especially in basketball players and distance runners.
 Pain below the kneecap and, sometimes, above it
Tendonitis in the wrist – In the wrist, tendonitis commonly appears in the form of de Quervain’s disease, a condition that causes pain in the back of the wrist at the base of the thumb. Although de Quervain’s disease usually occurs in people who repeatedly grasp or pinch with the thumb, it sometimes develops during pregnancy or for no known reason.
* Pain at the back of the wrist, near the base of the thumb.
Achilles tendonitis – This form of tendonitis affects the Achilles tendon, the large ropelike tendon attached to the heel bone at the back of the foot. Achilles tendonitis usually is caused by overuse, especially in sports that require running or repeated jumping, and it accounts for 15% of all running injuries. Achilles tendonitis also may be related to faulty running technique or to poorly fitting shoes, if the back of the shoe digs into the Achilles tendon above the heel. Less often, Achilles tendonitis is related to an inflammatory illness, such as ankylosing spondylitis, reactive arthritis, gout or rheumatoid arthritis.
* Pain at the back of the heel or 2 to 4 inches above the heel.
External resources:
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Information Clearinghouse    
National Institutes of Health 1 AMS Circle
Bethesda, MD 20892-3675 Phone: 301-495-4484 Toll-Free: 1-877-226-4267 Fax: 301-718-6366
TTY: 301-565-2966
American Academy of Orthopaedic Surgeons (AAOS)
6300 North River Road Rosemont, IL 60018-4262 Phone: 847-823-7186 Toll-Free: 1-800-346-2267 Fax: 847-823-8125
American Physical Therapy Association
1111 North Fairfax St. Alexandria, VA 22314-1488 Phone: 703-684-2782 Toll-Free: 1-800-999-2782 TTY: 703-683-6748
Fax: 703-684-7343
American College of Rheumatology
1800 Century Place
Suite 250
Atlanta, GA 30345-4300
Phone: 404-633-3777
Fax: 404-633-1870
Arthritis Foundation
P.O. Box 7669
Atlanta, GA 30357-0669 Phone: 404-872-7100 Toll-Free: 1-800-283-7800