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Tendonitis

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By: Dr. Stephen O’Neil

Many patients present to my office for treatment of various forms of tendonitis. Some of these patients don't really know what tendonitis is, they only know that they are experiencing pain and weakness and someone had made the diagnosis of tendonitis. Tendonitis literally translates to inflammation or swelling of a tendon. The condition is characterized by a painful loss of strength. A tendon is a tough piece of soft tissue that attaches a muscle to a bone. The problem with a diagnosis of tendonitis is that the word itself is merely a description of a symptom. It gives no indication as to why the tendon is inflamed or the underlying cause of inflammation. Therefore, any treatment plan that is to be effective must not only address the inflamed tendon, but also the underlying cause of this inflammation. Tendonitis by itself is an incomplete diagnosis; it is more often a symptom of a more serious condition.

Initially, treatment consists of basic rest, ice, compression, and elevation of the involved area. Rest and ice would be the most important parts of these treatments. Rest will generally remove the stress causing the tendon to be irritated and ice will locally reduce the amount of inflammation present. Anti-inflammatory medications are also often prescribed to reduce inflammation, however they merely mask the symptoms. With symptoms absent, patients may then continue performing the stressor causing the tendonitis, which will further aggravate the condition.

Chronic tendonitis is usually caused by a repetitive stress of some sort. Repetitive motions, especially specific motions involving smaller muscles, are the major culprit. Typing, assembly work, exposure to vibration and running on the same side of the road are things that would fall into this category. If left untreated, the body will usually naturally compensate to reduce the stress and sometimes symptoms will resolve on their own. However, even though symptoms resolve, a muscle imbalance or altered range of motion will remain. This can lead to a more complicated tendonitis and possible problems in another area.

Acute tendonitis will often present more quickly after a trauma to an area or one major motion causing a stress to a tendon. A fall, jumping motion and overthrowing a baseball could cause a bout of acute tendonitis.

Long term care and prevention of tendonitis may include an orthopedic device to help support the injured area and restore proper biomechanics. Stretching and strengthening exercises to balance out muscle imbalances and restore normal muscular function and strength. Taping the afflicted area is often used to support a joint with tendonitis. Taping can change the angle of pull in a tendon and redistribute the stress to another area of the tendon or muscle. This however is usually a short term fix.

Complete and long term care of tendonitis must address all facets of the disorder. It is necessary to identify and eliminate the underlying cause of the inflammation or strengthen the afflicted area so it is more capable of dealing with the stressors involved. A long term management plan must include long term solutions and preventive measures. See your chiropractor for treatment possibilities and suggestions for permanent solutions.