Tendonitis is a pathological state of tendons, the connective tissues, characterized by inflammation. Associated with over use of muscles and old age, it experiences pain and irritation in the specific area.

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Tendon: A Tendon is a connective tissue. It connects the bones to muscles of a body characterized by its tough but flexible fibrous nature. Contraction of skeletal muscles results in bone movement. The structure of tendon serves as the media to propagate this contraction force and hence holds very important place in the body movements.

They are of varied sizes and shapes depending upon their function and location in the body. For example, the tendons attached at carpal or metacarpal of fingers are relatively smaller while the tendons like Achilles Tendon or Patellar Tendon are much larger. Their functioning is very smooth in normal conditions.

Tendonitis: Sometimes, these normal smoothly gliding movements get impaired. The whole motion of specific part of body becomes itchy, irritating and causing lot of pain. Due to many reasons, it becomes sore, inflamed. In medical terminology, this condition is better known as Tendonitis. A main constituent of tendon is collagen matrix, a fibrous structural protein which has great tensile strength. During Tendonitis, this matrix gets torn because of chronic overuse resulting ultimately in tissue weakening.

Common Causes
1.Chronic Overuse of tendons – This condition is mainly experienced in body builders, athletes where they start their activities without proper initial warm up. As the tendon can’t cope up with the sudden change in the parameters of actions, it gets inflamed.
2. Increasing Age factor – One of the most common causes normally experienced in later age. With increasing age, there is a sharp decline in the elastic properties of tendons that results in lessening tensile strength and become vulnerable to tendonitis.
3.Repetitive Stress – Individuals performing at job productions or sports persons performing repetitive movements of particular part of a body are prone to inflammation. Tennis Elbow is its best example.
4. Injury related – Some times as one tendon gets impaired, extra stress is laid on the neighboring tendon working in tandem with it. Due to extra stress, this condition arose.
5. Systematic Inflammatory Disease – In cases like Rheumatoid Arthritis, the probability of Tendonitis is much more.
6. Anatomical Cause – In very rare cases, tendon gets associated with rough surface or obstruction to glide against.

In most of the cases, when under pressure one starts feeling pain. This is normally the first symptom of Tendonitis. Movements become more and more restricted of the particular area and one starts experiencing itchy, burning sensation. In some cases, it even gets swollen, red. Thus symptoms may vary from mild irritation to severe ache. Symptoms are great indicator of development of Tendonitis and it is relatively easy to cure in early stages.

Generally, Tendonitis is diagnosed by physical examination only as symptoms are much more visible compared to other diseases. Swelling, redness or tenderness of tendon is visibly apparent. Pain with muscle movements is also another criterion. Also MRI (Magnetic Resonance Imaging) can be of great help to detect increased water content and even to distinguish ruptured collagen matrix.

Common Types of Tendonitis
1. Achilles Tendonitis-As the name itself shows, it is the inflammatory condition of Achilles tendon present at the back of the heel. Generally, it is characterized by swelling and pain. Early measures to be taken to cure it as it has the possibility of leading into further complicated rupture.
2. Wrist Tendonitis-Characterized by tenderness of tendon cover, it requires only medication and rest to heal.
3. Patellar Tendonitis-Commonly known as Jumper’s Knee, this inflammation is associated with Patellar tendon.
4. Rotator Cuff Tendonitis-Also known as Shoulder Bursitis, inflammation is associated with Rotator Cuff Tendon.
5. Tennis Elbow-Also known as Epicondylitis, associated with inflammation of tendons in elbow region. It has got its peculiar name as almost 50 percent of tennis players suffer from this problem. It can be cured by surgery, medication, rest and slow but steady return to exercise.

Immediate steps to be taken
The foremost thing to do is to stop those aggravating movements of particular area. This break plays a vital role in restoring tendon to its normal functioning. Also, the use of splint, strap, cap or brace is useful while protecting tendon from further damage. Application of ice pack on the inflamed area does wonders in the course of immediate treatment by controlling its swelling.

1. NSAID (Non Steroidal Anti Inflammatory Drugs) like Ibuprofen, Motrin, Celebrex acts as pain killer and decreases the inflammation by considerable amount.
2. If situation is not improved after the use of drugs and rest then, it is addressed by Cortisone Injections, which are injected directly at the exact location of damage.
3. Sometimes surgical treatment can be introduced like in cases of Tennis Elbow.
4. Proper Strengthening of Tendons is done under the watchful eyes of experts to lessen the exerted stress.

Due to the slow collagen restructuring process, the rate of healing is quite slow. One has to be always cautious as recurrence of trauma is common. However, recent research works have shown rays of hope with eccentric loading and injection of stem cells.

By Jayashree Pakhare
Published: 2/16/2007