Tendonitis is a condition caused by acute or chronic inflammation of a tendon. Many of us have probably experienced it at some time in our life. It occurs most commonly in the shoulders (rotator cuff tendonitis), elbows (tennis or golfer’s elbow AKA lateral or medial epicondylitis respectively), ankle (Achilles tendonitis), knee (patellar tendonitis), or wrist/hand. Symptoms usually present gradually, first with tenderness, pain, some swelling, redness, or heat. Severity of these symptoms may feel worst at the end of the day after use of that body part, and feel least severe in the morning after having rested while you sleep.
Tendonitis can occur over a long period of time (overuse) or by sudden injury. Overuse is most common and is usually what we see here at OSR in Kailua most often. This happens when a tendon is exposed to repetitive and strenuous movement for long periods of time. The tendon is stressed repetitively to the point where the strength of the tendon can no longer meet the demands put on it. Microtears occur in the tendon and inflammation follows to initiate tissue repair.
Inflammation is actually a normal response to our body’s need to heal. Its primary purpose is to eliminate whatever caused the injury in the first place. It then clears out necrotic or dying tissues damaged from the original injury. It is unclear exactly how tendinitis occurs, but some believe that the process of “clearing out dying tissue” occurs excessively as the tendon is persistently subjected to strain and subsequent injury (microtears). Overall, the tendon does not get enough rest between workloads, and so repetitive injury occurs faster than repair, and inflammation ensues. (Tendon + constant inflammation “-itis” = tendonitis).
An example of such an overuse injury often occur when training for a marathon. Many people start training at an strenuous level, running too many miles in such a short period of time. They can gradually develop Achilles or patellar tendonitis as their ankle or knees get overworked, failing to meet the demands of that level of training. Instead, one should slowly increasing their mileage and intensity at a more healthy and tolerable pace.