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Tendonitis

Another part of the body that can make our life miserable if we don’t take care of it rapidly. Yes, we are very fragile human-beings and we love to complain and whine. Don’t we love getting some attention from our close ones? Maybe more the men than women for some reason. Not sure why but it’s a fact. Men tend to seek attention more than women when they start feeling sick!

Anyway, back to Tendonitis. Tendons connect the muscles to your bones and are all over the body. Tendonitis occurs when there is irritation or inflammation of the tendon.

What is the cause of tendonitis?

Most often tendonitis is caused by repetitive movement, minor impact or sometimes by a sudden injury.

Activities that may cause tendonitis include – gardening, carpentry, painting, cleaning, raking and sports such as tennis, golf, skiing, throwing and pitching. Overuse or doing too much too soon (before your body gets used to complete the task) as is often the case when people do a lot on the weekends either in exercise or leisure. Stresses from other conditions such as arthritis, thyroid disorders, gout, and medication reactions can also attribute to tendonitis. Tendonitis can also be caused infection stemming from a cat or dog bite to the hand or finger.

What are some symptoms of tendonitis?

  • Difficulty moving tendon
  • A lump along the tendon
  • Pain that worsens when you move
  • Swelling which may or may not include heat and redness
  • Cracking or grating sensation when moving the tendon

What are the types of tendonitis?

  • Elbows- Golfers Elbow, Tennis elbow
  • Heels- Achilles tendonitis
  • Knees- Jumper’s knee (patellar tendonitis)
  • Shoulders- supraspinatus tendonitis, calcific tendonitis
  • Upper Arm- Biceps tendonitis
  • Wrists/Thumbs- de Quervain’s disease

How do you reduce the chances of tendonitis?

Before exercising or physical activity for sport, or fun, warm up! Make sure you stretch after too! Wear the appropriate shoe for the activity. Make sure you have a proper fit and replace shoes regularly. Take breaks when you are doing a repetitive task- stretch, change or alternate tasks.

How can we help?

At Pillars of Wellness, our physiotherapist will complete a full assessment including health history, physical assessment, visual assessment and questions regarding the concern, symptoms and goals. If required, they may refer you to an MD for further diagnosis. Our goal is to help you return to your daily activity as quickly as possible.

Golfers elbow – Medial Epicondylitis

Although the name surely covers a majority of those who suffer from this is can affect those who are not golfers as the cause can also be a sudden trauma or overuse. With Golfers Elbow, the pain generally is felt in the outer elbow and can occur during activity or while resting.

As with most injuries a prudent assessment, correct diagnosis, and treatment can reduce the pain and prevent disability. At Pillars of Wellness, your Physiotherapist will provide you with a specific program based on your personal assessment, review of lifestyle, current and past health history, injury and goals. We will work with you to reduce or eliminate pain and to help you return to optimal function and activity. Part of the Pillars of Wellness physiotherapy process includes support and education to prevent re-injury as sometimes we can do the same activities differently but need guidance on how to safely do so.

Tennis elbow - Lateral Epicondylitis

Tennis Elbow can affect anyone, not just tennis enthusiasts, as it is caused by muscle overuse resulting in inflammation and subsequent pain on the outside area of the elbow. Tennis Elbow also is typically accompanied with tremendous sensitivity in the area.

As elbows affect our day-to-day activity, its vital to treat early as you can cut recovery time down significantly if treatment is started when there is just inflammation present. Left unchecked and untreated Tennis Elbow can progress to tendonitis which in turn can cause muscle fibers to breakdown. A significant breakdown in muscle fibers prolongs recovery and healing and can result in surgery being needed.

Pillars of Wellness physiotherapists are able to prevent the progression of Tennis Elbow. After reviewing your current and past health history, completing various specific tests and assessments they will then prescribe a treatment plan to get you to reduce or eliminate pain and inflammation and get you moving! You will learn exercises as well as ways to modify and adapt the activities that may have caused you to have Tennis Elbow.

Achilles tendonitis

Achilles Tendonitis is an injury resulting from overuse of the Achilles tendon (heel cord or calcaneal tendon) which is the tendon at the back of the lower leg connecting the calf muscle to the heel bone. As the thickest tendon in the entire human body, the Achilles attaches the plantaris, calf (gastrocnemius) and soleus muscles to the heel (calcaneus) bone. Achilles Tendonitis is common in runners who are increasing their running activity level either by the distance or intensity. It is also quite common in the over 35 age group who find themselves mostly active on weekends and participate in sports such as tennis and basketball. In very serious cases tendonitis can lead to a tear that requires surgery however most cases are easily managed.

Achilles tendonitis is typically marked by pain that starts as a mild ache in the back of the lower leg and or above the heel after a run or activity. Symptoms can increase to more severe pain with extended, prolonged or burst activity such as sprinting. Some people also note stiffness and tenderness, typically in the morning, that improves with use and mild activity.

Although more common as we age, and in men, there are other risk factors for Achilles tendonitis. These can include medical conditions such as high blood pressure, obesity, flat arches, wearing worn running shoes, and use of Fluoroquinolone antibiotics.

Although you might not be able to prevent Achilles tendonitis, you can implement strategies to reduce the risk! It can be as simple as wearing properly fitting shoes with good arch support and adequate heel cushioning. Of course, you will have to replace your shoes with use and likely more often than you might think. Another excellent strategy is to build up the muscles that support the tendon- strengthening your calf muscles will take some burden off the Achilles and can prevent injury! Cross-training may be an effective prevention option as it allows your body to recover especially if you alternate impact activities with non-impact activities such as running and swimming. Stretching before and activity will help to maintain flexibility and potentially prevent Achilles tendonitis. When starting a new activity or elevating your current activity level start slowly by gradually increasing duration and intensity. Limit activities, such as a running hill, that can place more stress and strain on your Achilles. If, and when, you do participate in those more strenuous activities remember the importance of an effective and good warm up (this may include the same activity as a slower) pace. As always, if you notice pain during a specific exercise, stop, rest and potentially modify the activity.

Physiotherapists at Pillars of Wellness often treat those experiencing Achilles Tendonitis. They will assess you individually and work with to reduce inflammation, if present, and also to reduce and eliminate pain. They will also provide you with specific exercises to help your tendon to regain strength while healing and share ways in which to prevent further injury and future injury.

Jumper's knee- Patellar Tendonitis

Jumper’s Knee is an overuse injury that can appear to be a small annoying injury that is not too bad and will often be overlooked especially in athletes. It is quite common in athletes that repetitively strain the knee through jumping and running but may also be caused by degeneration of the patella tendon. As the recovery of this is dependent on rest combined with treatment and rehab, ignoring symptoms will potentially worsen the condition or cause it to become chronic in nature. With Jumper’s knee, most have pain in the front of the knee that is closer to the bottom of the kneecap and may be localized. Some experience redness over the area.

Graded from 1 to 4 Patella tendon injuries range from:

  • Grade 1- post-training pain
  • Grade 2- pre and post training pain that subsides or eases up after warming up
  • Grade 3- performance affected due to pain during training
  • Grade 4- persistent pain in every day occupation and activities

At Pillars of Wellness our Physiotherapists will complete a full assessment. They will find out about past events leading up to the injury, activity levels, health, and previous injuries. This process includes a series of physical and visual/ observational tests, a range of motion examination, resistance and functional tests. Your individual treatment plan will be based on the discovery and diagnosis and will include education on prevention and modification.

Shoulder tendonitis- supraspinatus tendonitis, calcific tendonitis

The supraspinatus tendonitis is caused by repetitive throwing and overhead motion in athletes. It can also occur due to falls directly on shoulder, degeneration and in conjunction with inflammatory disorders like rheumatoid arthritis. Symptoms may include pain and weakness in the arm as well as tenderness on the front and inside of the upper arm where attachment occurs to the humerus bone.

Calcific tendonitis

Calcific Tendonitis is caused by calcium deposits in the tendons of the rotator cuff. They are typically 1-2 cm in size and are common in those 40 to 60-year age group with increased incidence in women as well as in those who suffer from diabetes. It is a common cause of shoulder pain however approximately 1/3 of those affected by it do not experience any symptoms. Pain is described as being in the front or back of the shoulder and into the arm and can build gradually or come on quite suddenly. Some people have difficulty sleeping due to severe pain or cannot move their arm.

There are 3 stages for the calcium deposits.

Pre-calcification- typically there is no pain and/or symptoms at this stage. Cellular level changes can be noted. Calcific- cells excrete calcium which forms into deposits. There is no solid formation and its chalky in appearance- this tends to be a pain-free phase which is followed by a resting phase. After resting, there is a resorptive phase which painful and the calcium deposit is much thicker. Post-calcific- typically a painless phase as the deposit disappears and begins to appear like normal tendon.

Physiotherapists will work with you to return an optimal range of motion through the use of exercise and other modalities.

Biceps tendonitis

Often resulting in pain at the front of the shoulder that worsens at night, Biceps tendinitis is usually a repetitive work or athletic injury resulting in inflammation of the bicep tendon. Symptoms may progress when pulling, lifting or reaching overhead repeatedly. It is important to have this assessed and treated as soon as possible to avoid potential tearing of the tendon, avoid further deterioration and delay recovery.

De Quervain's disease

When the tendons are inflamed and painful at the base of the thumb it is de Quervain’s disease. This occurs when the pulley system for the tendon (synovium) is irritated and therefore cannot glide. The result is catching or snapping sensation and it sometimes presents as swelling or a cyst with fluid on the thumb side of the wrist. Key indicators are a pain when grasping and/or gripping objects, difficulty moving thumb and wrist, and pain when making a fist and or turning the wrist.

After a long explanation of what is Tendonitis and how to treat it, I’m hoping you will anticipate this problem because we can prevent it or at least reduce the chance of getting such discomfort or pain by being more aware of our movement, our surrounding and change our habits.

While we have been mostly recommending physiotherapy, it is important to note that chiropractors are very skilled and trained in a similar fashion that physiotherapist and can treat any sports injuries or musculoskeletal condition including chronic pain. In addition, chiropractors are also trained to treat a neurological condition related to your spine. Dr. Amrit is one of the leading chiropractors in Burlington and focuses on active release technique or soft tissue.

If nothing works for you, then you have only one thing to do…call us!! 905-637-4000 – info@pillarsofwellness.ca – www.pillarsofwellness.ca

Laurent Pinci
Laurent Pinci
Pillars of Wellness is a truly Integrated Healthcare Centre providing a high degree of collaboration and communication among health providers.