What are Tendons?

A Tendon will connect your muscle tissue to the bone structure. Tendons are flexible but inelastic cords of strong fibrous collagen tissue.

Tendons are located around every joint.

What is Tendonitis?

Tendonitis is the process where the tendons holding the muscles to the bones become inflamed.

Damage to the tendons starts with very small tears in the fibres. This is associated with inflammation and pain. If healing is incomplete the tendon degenerates (ischaemic damage). The length of time it takes to heal tendonitis is determined by the extent of the degeneration that has occurred. If there is no degeneration the tendonitis will resolve in days or weeks. Significant degeneration can takes two years or more to resolve. If you do not identify the damage and take positive steps to correct the degeneration it can progressively worsen and eventually the tendon may rip apart. At this point surgery is needed to rejoin the ends of the ruptured tendon.

Tendonitis can occur due to either;

  • Injury
  • Overuse
  • Repetitive Motion
  • Infections
  • Rheumatic Fever

tendon damage

Identifying Tendon pain as opposed to Arthritic pain

The pain of arthritis is typically inside the joint and not changed by pressing on the skin over the joint. If you can find a tender spot that indicates that something outside the joint is inflamed. This could be tendonitis, bursitis, stretched ligament, Bakers cyst, enthesitis or capsule irritation. All of these will improve with rest and warmth.

Tendon pain can occur the day after activities or exercise and it can be very sharp, to a point where the movement is extremely affected and the pain is debilitating.

The pain will often ease off as the joint is warmed up due to increased blood flow and whilst the joint is at rest.

Arthritic pain can be felt as a dull ache or as a burning pain inside the joint. When severe it may be difficult to separate the pain from tendonitis arising outside the joint. Everywhere hurts. Separating pain of tendonitis from the pain of osteoarthritis can be difficult but with a bit if practice and if you can find a tender spot on the outside of the joint, diagnosis will be easier.

  • When the OA is in your knees this is most commonly felt as tenderness on the medial aspect of the joint and upper tibia. (Pes Anserinus Bursitis).
  • For patients with hip OA the pain is more commonly felt in the pelvis across the sacro-iliac joint and up into the lower spine.

Treating Tendonitis

Treating tendonitis can be tedious. It requires 5 steps to return the tendon back to normal function.

  1. Plasma Injections
    We are able to treat Tendonitis with the use of  the plasma injections. The plasma contains growth factors which can naturally speed up the recovery process of the inflamed or damaged tendon.
  2. Physical Therapy
    Phsyio or Hydro-therapy is extremely important, these tendons have lost their strength and flexibility. You have to build this back up, it is not possible without training them.
  3. Rest
    When the tendons have become severely inflamed, you need to stop and rest. Do not over stress the tendon, this can create a bigger problem.
  4. Heat NOT Cold
    Keeping the tendons warm will allow increased blood flow, blood contains nutrients aid in recovery and it also contains natural anti-inflammatories which can reduce the pain.
    Using ice packs on tendonitis can often make the situation much worse since the cold will restrict blood flow to the tendon. They already have a poor blood supply, do not exacerbate this.
  5. Patience
    In severe cases it can take up to 2 years for tendonitis to resolve. If you are not patient and persistent you will not resolve the tendonitis.