Tendon injuries like Tendinitis (also tendonitis), meaning inflammation of a tendon, is a type of tendinopathy often confused with the more common tendinosis, which has similar symptoms but requires different treatment. (The suffix -itis denotes diseases characterized by inflammation.) The term tendinitis should be reserved for tendon injuries that involve larger-scale acute injuries accompanied by inflammation. Generally tendinitis is referred to by the body part involved, such as Achilles tendinitis (affecting the Achilles tendon), or patellar tendinitis (jumper’s knee, affecting the patellar tendon).
Tendon Injuries by Types
Tendinitis injuries are common in the upper and lower limbs (including the rotator cuff attachments), and are less common in the hips and torso. Individual variation in frequency and severity of tendinitis will vary depending on the type, frequency and severity of exercise or use; for example, rock climbers tend to develop tendinitis in their fingers or elbows, swimmers in their shoulders. Achilles tendinitis is a common injury, particularly in sports that involve lunging and jumping, while Patellar tendinitis is a common among basketball and volleyball players due to the amount of jumping and landing. A veterinary equivalent to Achilles tendinitis is bowed tendon, tendinitis of the superficial digital tendon of the horse.
Symptoms can vary from aches or pains and local joint stiffness, to a burning that surrounds the whole joint around the inflamed tendon. In some cases, swelling occurs along with heat and redness, and there may be visible knots surrounding the tendon. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiff the following day as muscles tighten from the movement of the tendon. If the symptoms of tendinitis last for several months or longer it is probably tendinosis.
Treatment of tendon injuries is largely conservative. Use of non-steroidal anti-inflammatory drugs (NSAIDs), rest, gradual return to exercise and physical therapy are all beneficial. Resting assists in the prevention of further damage to the tendon. Ice, compression and elevation are also frequently recommended. Physical therapy, occupational therapy, orthotics or braces may also be useful. Initial recovery is typically within 2 to 3 days and full recovery is within 4 to 6 weeks. Tendinosis occurs as the acute phase of healing has ended (6–8 weeks) but has left the area insufficiently healed; Treatment of tendinitis helps reduce some of the risks of developing tendonosis, which takes longer to heal.
Steroid injections have not been shown to have long term benefits but have been shown to be more effective than NSAIDs in the short term.
In chronic tendinitis or tendonosis laser therapy has been found to be better than conservative treatment at reducing pain; however, no other outcomes were assessed. Both prolotherapy and PRP injections are being used more frequently with good clinical short and long term outcomes in tendonosis – research has been only slightly positive for these treatment modalities due to the poor design of many of the completed studies.