What can PT do for Tendonitis?
Tendonitis is inflammation of a tendon. A tendon connects a muscle to a bone. Tendons become inflamed with overuse or repetitive motions, and sometimes with direct trauma. It occurs near joints as this is where muscles attach to bones to produce movement. When the tendon is inflamed, it becomes painful to use the muscle. Over time, if left untreated, the tendon can become scarred and thickened, leading to tendonosis and chronic pain.
Signs and Symptoms:
Tendonitis is characterized by pain with movement, that initially becomes better, but with repetitive stress becomes more painful. Rest improves the symptoms.
Most Common Sites for Tendonitis:
- The biceps/rotator cuff. These muscles attach into the shoulder and are used any time the arm is lifted. The biceps produces pain at the anterior shoulder and with lifting to shoulder level or carrying heavy items. It may be produced with throwing motions also. Rotator cuff tendonitis can be felt in a number of areas including the front of the shoulder, back of the shoulder or side of the shoulder depending on which tendon is actually involved. Your physical therapist can determine this for you. It is also characterized by pain with lifting or throwing or other overhead motions.
- The knee/patellar tendon. This is located just below the knee cap and occurs most frequently in runners and jumpers, and is given the common term of runner’s/jumper’s knee. Pain occurs during these motions.
- The elbow. Common terms for tendonitis in the elbow are tennis elbow or golfers elbow ( see Elbow Pain for more information). Tennis elbow occurs near the elbow on the top of the forearm when the palm is down. Golfers elbow occurs near the elbow on the underside of the forearm when the palm is face down. Tennis elbow commonly occurs in office workers who spend a lot of time typing or using a mouse, as well as tennis players. Golfer’s elbow is less common and occurs in golfers as well as throwing athletes.
- Achilles Tendon. The achilles tendon is the thick band that connects the calf muscles to your heel. It often becomes inflamed in athletes who jump and run and make sahrp cuts, but also in women who wear high heeled shoes (often accompanied by Haglen’s deformity - a large nodule at the attachment of the achilles on the heel).
What to do:
- Keep moving, but modify the intensity or number of repetitions you are performing of the movement that hurts.
- Ice! Use an ice pack for 10-15 minutes or perform ice massage for 5-7 minutes to reduce the inflammation and pain every few hours as necessary.
- Sometimes moist heat can be used to help with stiffness if the problem has been going on for awhile, but icing following activity is recommended.
- See a physical therapist. Often the cause of the tendonitis can be traced to weakness in other nearby muscles causing an imbalance or overuse. A physical therapist can identify these imbalances and demonstrate exercises and stretches to correct the problem, as well as perform manual techniques to maintain range of motion, promote tissue healing, and reduce pain.