Tendonitis Symptoms, Causes, and Treatments

Tendonitis (also spelled tendinitis) is inflammation or irritation of a tendon, the flexible, fibrous cords that connect muscles to bones. Tendonitis causes pain, swelling, loss of mobility, and decreased joint strength.

A type of tendinopathy, tendonitis can affect any tendon in the body. It is most common in shoulders, elbows, wrists, knees, and heels and is typically caused by repetitive use. Rest and preventing re-injury are the core of any tendonitis treatment plan.

This article discusses tendonitis and its symptoms. It also explains when tendonitis warrants medical attention, possible causes, and common locations. It also details how tendonitis is diagnosed, treated, and prevented.

Tendonitis Symptoms

Tendonitis generally causes sudden pain and inflammation. In some cases, though, symptoms come on gradually, often after a period of excessive activity but no significant injury.

The most common symptoms of tendonitis include:

• Swelling of the tendon
• Tenderness directly over the tendon
• Pain with movement
• A cracking or grating sensation when the joint is moved
• A lump or bulge on the tendon itself
• Stiffness due to swelling

When to See a Healthcare Provider

You should see a healthcare provider for tendonitis:

• If the pain doesn't improve in a few days
• You have recurring tendon pain
• Your symptoms are severe
  

Tendonitis Causes

You have hundreds of tendons throughout your body, but only a handful are affected by tendonitis. These tendons tend to be connected to fewer blood vessels, and the lack of blood supply hinders their ability to heal after injury.

Common causes of tendonitis include:

• Sudden or forceful motions (heavy lifting, pitching a baseball)
• Unnatural or extreme motions (dancing, serving a tennis ball)
• Poor body mechanics when performing physical activities (working out, painting a house)

Chronic tendonitis is most often caused by overusing a tendon as you work, play sports, or perform other daily activities. It's especially tied to repetitive movements such as you'd use on an assembly line or in sports like golf or tennis.

Direct injury—such as a blow to the tendon—can also cause tendonitis. So can inflammatory disorders like rheumatoid arthritis and osteoarthritis.

Risk Factors

Factors that make you more likely to develop tendonitis are:

• Age: While young athletes often have tendonitis, it becomes more common with age and is most common in people over 40 and especially after menopause. This is because tendons lose their flexibility over time.
• Sex: Those assigned male at birth (AMAB) are more likely to have tendonitis in the Achilles, hip adductor, and knee tendons. Those assigned female at birth (AFAB) are more likely to have it in the gluteus medius tendon in the hip.
• Obesity: This condition can place additional strain on your tendons, especially the ones in your legs and feet.
  
• Diabetes: The condition tends to cause thicker and abnormal tendons.
• Participating in certain sports: Sports that are highly associated with tendonitis include volleyball, track and field, tennis, golf, swimming, baseball (especially pitching), basketball, football, and soccer.
• Smoking: Cigarette smoking changes your tissues and makes you 1.5 times more likely to have overuse tendonitis.

Job-related risk factors include:

• Repetitive movements
• Heavy lifting, especially above the shoulders or head
• Regular or constant exposure to vibration
• Awkward shoulder postures

Some of these risk factors (like age) can't be changed. However, you do have control over some of them. You may want to explore safety measures you can take at work or while playing sports.

Common Tendonitis Types and Locations

Tendonitis is typically classified by its location. Some of the more common types include:

• Achilles tendonitis, involving the tendon between the calf muscle and heel
• Patellar tendonitis, sometimes called "jumper’s knees"
• Elbow tendonitis, commonly called tennis elbow or golfer's elbow
• Biceps tendonitis, typically involving the tendon between the biceps muscle and the shoulder
• Rotator cuff tendonitis, known as swimmer’s shoulder
• Wrist tendonitis, sometimes called bowler’s wrist

Tendonitis Diagnosis

Healthcare providers often diagnose tendonitis based on a description of your symptoms and a physical examination.

If the cause isn't clear, they may order additional tests such as X-rays and magnetic resonance imaging (MRI).

MRI shows the soft tissues, so it's good for spotting tendon problems. X-rays are more useful for ruling out injuries to the bone.

Tendonitis Treatment

The main objective of tendonitis treatment is to minimize movements that can further inflame the tendon. Depending on where it is, you may need to reduce or modify everyday tasks like driving or typing until symptoms are fully settled.

To start treating tendonitis before you see a healthcare provider, you can use:

• Rest
• Ice
• Non-steroidal anti-inflammatory drugs like Advil (ibuprofen) or Aleve (naproxen)

Medical treatment of tendonitis involves three elements:

• Limiting movement
• Reducing inflammation
• Rehabilitating the injured tendon, joint, and muscle

As part of this, you may be given a wrist, brace, or splint to wear. It can help immobilize and relieve pressure on the afflicted tendon.

You may also benefit from steroid injections, physical therapy, or, in severe cases, surgery.

Tendonitis Prevention

If you're at risk of tendonitis, you may want to take steps to prevent it (or keep it from coming back).

If you're an athlete:

• Be sure to warm up thoroughly before working out and cool down afterward.
• Before starting a new sport, spend a few weeks or months stretching and strengthening new muscles you'll use.
• Learn the proper way to use athletic equipment.
• Work out several times a week.

At work or when performing daily tasks:

• Take regular breaks.
• Change your activity type frequently.
• Wear splints, wraps, or other supportive devices to protect tendons with heavy use.
• Improve your overall strength and flexibility.

You can also look at modifiable risk factors, such as smoking and your weight.

Summary

Tendonitis involves inflammation of a tendon. It can be caused by injury, repetitive use, or inflammatory disease. It's more common if you're an athlete, have a physical job, are over 40, have obesity or diabetes, and smoke cigarettes.

Common locations are the Achilles tendon, knee, wrist, elbow, bicep, and shoulder. Common symptoms are pain, swelling, and stiffness.

Tendonitis can be diagnosed with a physical exam and possibly imaging studies. Treatments include immobilization, ice, steroid injections, physical therapy and surgery. You can prevent tendonitis by staying in shape, losing weight, and training for new activities.