What Is Tendonitis?

Tendons are the fibrous structures that connect muscles to bones. When they become swollen or inflamed, it is called tendonitis. Tendons may become inflamed as a result of overuse or repetitive motion. Tendonitis can affect anyone but is most common among athletes or those who repeatedly perform the same set of tasks or movements.

Types of Tendonitis

Tendonitis can affect different parts of the body, leading to various classifications. The most common types are: 

  • Achilles tendonitis affects the Achilles tendon at the back of the ankle.
  • Bicipital tendonitis is experienced as front shoulder pain due to injury to the biceps tendon. 
  • De Quervain’s tenosynovitis results in pain in the tendons on the thumb side of the wrist. 
  • Golfer’s elbow (medial epicondylitis) results in difficulty gripping or flexing the wrist due to repeated use of the forearm muscles.  
  • Hamstring tendonitis is pain at the back of the thigh, along with difficulty bending the leg. 
  • Hip flexor tendonitis affects the tendons in the hip flexor muscles at the front of the hip. It is most noticeable when running or climbing stairs. 
  • Jumper’s knee (patellar tendonitis) is caused by repetitive jumping or running. It results in pain just below the kneecap that worsens with activity. 
  • Rotator cuff tendonitis affects the rotator cuff tendons in the shoulder, resulting in difficulty lifting the arm. 
  • Tennis elbow (lateral epicondylitis) is pain or tenderness in the tendons on the outside of the elbow that worsens with lifting or gripping. 
  • Wrist tendonitis results in limited wrist motion and is typically caused by repetitive motions like typing or sports. 

Causes of Tendonitis

Common causes of tendonitis include repetitive motions, overuse of a muscle group, arthritis and trauma to the affected area.

Tendonitis can result from injury or overuse, and playing sports is a common cause. It can also occur with aging as the tendon loses elasticity. Diseases such as rheumatoid arthritis or diabetes can also lead to tendonitis. Tendonitis can occur in any tendon, but it commonly affects the elbow, heel (Achilles tendonitis), knee, shoulder, thumb and wrist.

Risk Factors for Tendonitis

Tendonitis can result from overuse or repetitive movements, such as playing sports or occupations that require excessive typing. Poor technique and form, sudden increases in activity and muscle imbalances increase the risk of tendonitis.

Screening for & Preventing Tendonitis

To prevent tendonitis, it’s essential to use proper form and take regular breaks when performing repetitive motions. Additionally, it’s a good idea to warm up the affected muscle group before activities, stretch before and after activities and strengthen muscles surrounding the affected area.

Tendonitis can be prevented by:

  • Avoiding repetitive motions and overuse of the arms and legs
  • Keeping all your muscles strong and flexible
  • Performing warm-up exercises at a relaxed pace before engaging in vigorous activity

Signs & Symptoms of Tendonitis

Symptoms of tendonitis can include swelling, soreness, stiffness or burning in the area around the affected tendon, pain when the tendon is used or tenderness when the area is touched.

Symptoms of tendonitis may vary with the activity or cause. Primary symptoms may include:

  • Pain and tenderness along a tendon, usually near a joint
  • Pain at night
  • Pain that is worse with movement or activity
  • Stiffness in the morning
  • Inflammation of the tendon and warm, red skin

Diagnosing Tendonitis

Tendonitis is typically diagnosed through a physical examination and a review of your medical history. Your doctor may also order imaging tests, such as an X-ray, ultrasound or magnetic resonance imaging (MRI) scan, to look for signs of inflammation. Blood tests and/or other laboratory tests may also be ordered to confirm a diagnosis.

Your healthcare provider will perform a physical exam. During the exam, your provider will look for signs of pain and tenderness when the muscle attached to the tendon is moved in certain ways. There are specific tests for specific tendons.

Treating Tendonitis

The goal of treatment is to relieve pain and reduce inflammation. Your provider will recommend resting the affected tendon to help it recover, which may be done using a splint or a removable brace. Applying heat or cold to the affected area can help.

Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen, can also reduce pain and inflammation, and steroid injections into the tendon sheath can be beneficial for controlling pain. Your provider may also suggest physical therapy to stretch and strengthen the muscle and tendon. This can restore the tendon’s ability to function properly, improve healing, and prevent future injury. In rare cases, surgery is needed to remove the inflamed tissue from around the tendon.

The team of specialists at the Department of Physical Medicine and Rehabilitation may also address tendonitis and its symptoms with the following treatment plans: 

  • Home exercises
  • Activity modification, if necessary
  • Treatment with anti-inflammatory medication, as needed
  • Local corticosteroid injections, as needed
  • Non-opioid-based pain management

Living with Tendonitis

Tendonitis symptoms typically improve with treatment and rest. If the injury is caused by overuse, a change in work habits may be needed to prevent the problem from returning.

Complications of tendonitis may include long-term inflammation, which raises the risk of further injury, and a return of symptoms if not adequately treated.