The heel and elbow joints
are common sites of tendon injuries. For more information about tendon injuries
in these areas, see the topics
Achilles Tendon Problems and
This topic does not address
severe tendon tears or ruptures. To help you assess a tendon injury, see the
Shoulder Problems and Injuries,
Knee Problems and Injuries,
Finger, Hand, and Wrist Injuries, or
Toe, Foot, and Ankle Injuries.
Tendons are the tough fibers that connect muscle to
bone. For example, the
Achilles tendon connects the calf muscle to the heel bone. Most tendon
injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A
tendon injury may seem to happen suddenly, but usually it is the result of many
tiny tears to the tendon that have happened over time.
may use different terms to describe a tendon injury. You may hear:
Most experts now use the term
tendinopathy to include both inflammation and
microtears. But for many years most tendon problems were called "tendinitis." Many doctors still use this familiar word to describe a
Most tendon injuries
are the result of gradual wear and tear to the tendon from overuse or aging.
Anyone can have a tendon injury. But people who make the same motions over and
over in their jobs, sports, or daily activities are more likely to damage a
A tendon injury can happen suddenly or little by little.
You are more likely to have a sudden injury if the tendon has been weakened
Tendinopathy usually causes
pain, stiffness, and loss of strength in the affected area.
The symptoms of a tendon injury can be a lot like those
To diagnose a
tendon injury, a doctor will ask questions about your past health and your
symptoms and will do a physical exam. If the injury is related to your use of a
tool or sports equipment, the doctor may ask you to show how you use it.
If your symptoms are severe or do not improve with treatment,
your doctor may want you to have a test, such as an
In most cases, you can treat a
tendon injury at home. To get the best results, start these steps right away:
As soon as you are better, you can return to your
activity, but take it easy for a while. Don't start at the same level as before
your injury. Build back to your previous level slowly, and stop if it hurts.
Warm up before you exercise, and do some gentle stretching afterward. After the
activity, apply ice to prevent pain and swelling.
If these steps
don't help, your doctor may suggest physical therapy. If the injury is severe
or long-lasting, your doctor may have you use a splint, brace, or cast to hold
the tendon still.
It may take
weeks or months for a tendon injury to heal. Be patient, and stay with your
treatment. If you start using the injured tendon too soon, it can lead to more
To keep from hurting your tendon again, you may need to
make some long-term changes to your activities.
Learning about tendinopathies:
tendinopathy can include:
The joint areas most commonly affected by tendinopathy are
the shoulder, elbow, wrist, hip, knee, and ankle.
pain is caused by inflammation around calcium crystals in or around the tendon
(calcific tendinitis). The cause of the deposits often
isn't known. These crystal deposits can be quite painful and can become a
tendinopathy may be similar to those of inflammation of the bursa (bursitis).
For more information, see the topic
To diagnose a tendon injury (also known
tendinopathy), your doctor will review
your medical history and daily activities and conduct a physical exam to
check your overall health, areas of pain and tenderness, and range of motion
and strength. Your exam may also include checking your nerve function
(feeling and reflexes) and blood circulation (pulses). If your symptoms are
related to use of a tool or sports equipment, your doctor may want
you to demonstrate how you use it.
If your medical history and
physical exam point to a tendon injury, you will probably not need more
If your symptoms are severe or have not improved with
treatment, more tests may be helpful. These may include:
Initial treatment for a tendon
injury (tendinopathy) typically includes rest and pain
Acetaminophen can reduce pain. Nonsteroidal
anti-inflammatory drugs (NSAIDs) can reduce both the pain and
inflammation you might have from a tendon injury. The goals of this early
treatment are to:
If you are still having pain, stiffness, and weakness after
initial treatment, your doctor may recommend some type of
physical therapy. Also, you may need to make
long-term changes in the type of activities you do or how you do them to
prevent your tendinopathy from returning. The goals of ongoing treatment are
Take the following steps to treat tendinopathies:
If these steps do not help to relieve pain, other treatment
may be considered. Your doctor may:
Medical researchers continue to study new ways to treat
tendon injuries. Talk to your doctor if you are interested in experimental treatments. Some of the treatments being studied include:
Arthroscopic surgery or open surgery (using one larger incision) is sometimes used to treat
calcific tendinitis that has not responded to nonsurgical treatment and is
You can prevent a tendon injury (also
tendinopathy) from developing or recurring by taking
steps at home, work, and during activities to promote healing and protect your
Home treatment steps include:
To prevent tendon injuries from developing or from
See the following for ways to
ease a specific joint problem:
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
The American College of Rheumatology (ACR) and the
Association of Rheumatology Health Professionals (ARHP, a division of ACR) are
professional organizations of rheumatologists and associated health
professionals who are dedicated to healing, preventing disability from, and
curing the many types of arthritis and related disabling and sometimes fatal
disorders of the joints, muscles, and bones. Members of the ACR are physicians;
members of the ARHP include research scientists, nurses, physical and
occupational therapists, psychologists, and social workers. Both the ACR and
the ARHP provide professional education for their members.
website offers patient information fact sheets about rheumatic diseases, about
medicines used to treat rheumatic diseases, and about care
The National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS) is a governmental institute that serves the public
and health professionals by providing information, locating other information
sources, and participating in a national federal database of health
information. NIAMS supports research into the causes, treatment, and prevention
of arthritis and musculoskeletal and skin diseases and supports the training of
scientists to carry out this research.
The NIAMS website provides
health information referrals to the NIAMS Clearinghouse, which has information
packages about diseases.
CitationsHurt G, Baker CL (2003). Calcific tendinitis of the
shoulder. Orthopedic Clinics of North America, 34(4):
567–575.Other Works ConsultedColburn KK (2011). Bursitis, tendinitis, myofascial pain, and fibromyalgia. In ET Bope et al., eds., Conn's Current Therapy 2011, pp. 1011–1015. Philadelphia: Saunders.Coombes BK, et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. Lancet, 376(9754): 1751–1767.Klaiman MD, Fink K (2005). Upper extremity soft-tissue injuries. In WR Frontera et al., eds., Physical Medicine and Rehabilitation: Principles and Practice, 5th ed., vol. 1, pp. 907–922. Philadelphia: Lippincott Williams and Wilkins.McMahon PJ, Kaplan LD (2006). Sports medicine. In HB
Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 163–220. New York: McGraw-Hill.Mercier LR (2008). The knee. In Practical Orthopedics, 6th ed, pp. 215–251. Philadelphia: Mosby Elsevier.
October 16, 2012
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
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