A Complete Guide To Tendon Disorders And Treatment Options

While this is mostly associated with active individuals, tendon disorders can happen to anyone participating in recurring daily activities. This type of injury can affect the everyday functioning of life and the ability to do physical tasks because of pain, discomfort, and reduced mobility.

Fortunately, effective therapies can treat the many types of tendon conditions that can occur and lead to full recovery.

Here’s a complete guide to tendon disorders and the treatment options available.

• What Are Tendon Disorders 

Tendon disorders are medical conditions that affect the functionality of tendons anywhere in the body. Tendons are flexible and fibrous bands of tissue that connect muscles to bones and other structures in your anatomy.

They allow the limb movement necessary to bend, run, jump, walk, rotate, and perform complex motions. This also means they’re prone to strain and injury when overused and stretched, where tearing can occur. In normal conditions, tendons glide smoothly when muscles contract when you move.

However, during a tendon disorder, this movement is accompanied by pain and discomfort as the tendon becomes inflamed and swollen.  This is why they’re also known as musculoskeletal injuries. Tendon disorders are named according to their cause and their type of injury. These are categorized as follows:

• Tendonitis: The term tendonitis refers to the tendon disorder or injury caused by severe swelling and inflammation.
• Tendinosis: This is the chronic condition when tendon disorders or injuries are caused by degeneration and without inflammation.
• Tendinopathy: This is the general and broad term for any tendon injury or disorder with painful conditions associated with both tendonitis and tendinosis.
• Tenosynovitis: The inflammation of the protective synovial sheath that surrounds a tendon.
• Paratenonitis: The inflammation of the protective paratenon sheath that surrounds a tendon.

Understanding the various types of tendon disorders and their causes is crucial for proper diagnosis and treatment. This will allow individuals to maintain optimal mobility and prevent further complications in their daily lives.

• Common Tendon Disorders: 

While tendons are found throughout your body from head to toe, some areas are more susceptible to tendon disorders because of common human activity. They are:

• Shoulder

Bicipital Tendinopathy: Bicep tendonitis is the inflammation of the long-head bicep tendon that connects the bicep muscles to the shoulder socket. At the progressive stage, the tendon swells and can discolor into a dark red. If a tear occurs, it can result in a bulge forming in the upper arm. Symptoms include pain and aching sensations in the front arm that increase with overhead arm lifts.

Rotator Cuff Tendinopathy: Also known as swimmers’ shoulder, this is the disorder of the tendons in the rotator cuff muscles of the humerus and scapula. This causes pain and weakness in the shoulder joint, which can develop into shoulder weakness and limited mobility, especially when performing overhead or rotating arm lifting movements.

• Elbow

Lateral Epicondylitis: Also known as tennis elbow, this is the inflammation or tearing of the tendons in the muscles on the lateral outer side of the upper elbow. Common symptoms include pain or a burning sensation on the outer elbow that begins gradually and worsens over time. This can weaken the grip, especially when holding, turning, or shaking objects with your affected arm.

Medial Epicondylitis: Also known as golfers’ elbow, this pain and inflammation of tendons on the medial inner side of the elbow – the opposite side of tennis elbow. It also affects the muscles located in the forearm and tendons that move the wrist, hands, and fingers. Pain begins and worsens during and after activities that involve constant gripping and twisting.  

Flexor Tendinopathy: Related to golfers and tennis elbow, this tendon disorder is caused by inflammation, tearing, or degeneration of the tendons of the inside of the elbow and below the forearm connected to the palm. Pain and stiffness are triggered by hand, wrist, and arm movements that involve bending and flexing the elbow.

• Hand And Wrist

Extensor Tendinopathy: Inflammation of the extensor tendons that run from the forearms to the fingertips and connect bones and skin in the hands and fingers. The symptoms are jammed fingers, pain, swelling, and limited mobility where fingers can’t bend or straighten.

De Quervain’s Tenosynovitis: The inflammation and swelling of the tendon sheaths in the wrist and the underside of the thumb. Common symptoms are pain on the side of the wrist that shoots through the thumb and up the forearm. A cyst can form on your wrist below your thumb in progressive cases.

Trigger Finger: The tendon sheath surrounding a finger becomes irritated and swollen or can’t glide smoothly due to a cyst forming on the tendon. This can cause fingers to lock in a bent position and trigger symptoms such as pain, stiffness, and popping sensations in the fingers.

Dupuytren’s Contracture: A condition that causes fingers to pull in towards the palms and affects the skin tissue or fascia. The tendons in the palm thicken into a lump or shorten and contract and eventually pull the fingers forward. This is one of the few tendon disorders not characterized by pain or inflammation, mainly caused by genetics and underlying medical conditions.

• Knee

Patellar Tendinitis: Also known as jumpers’ knee, this disorder is an injury to the tenons that connect the kneecap to the shinbone. These tendons are attached to the front thigh muscles to allow jumping, walking, and running. When the patellar tendon is inflamed, it causes pain and weakness in the affected knee.

• Foot And Ankle

Achilles Tendinopathy: An injury or inflammation of the Achilles tendons that connect calf muscles to the heel bone of your legs. As the strongest and largest tendon in the body, it allows for leg movements such as running and jumping. This causes symptoms such as heel pain, ankle swelling, and stiffness in the lower calf muscles.

Peroneal Tendonitis: Pain and inflammation around the outer ankle and side of the foot. It affects the tendons attached to the peroneal muscles located on the outer ankle as they rub against the bone and cause irritation. Symptoms include pain on the border or instep of the foot and unstable walking when weight is applied to the ankle.

Understanding these common tendon disorders and their symptoms can help you better recognize potential issues in their early stages. Whether in the shoulder, elbow, hand, wrist, knee, or foot, early detection and management can prevent further complications, alleviate pain, and ensure a faster recovery.

• Causes

While mostly associated with athletes, tendon disorders can happen to any individual. This is because they’re caused by several factors ranging from lifestyle, injury and health conditions, and occupational work.

These are the most common reasons that tendon disorders develop include the following:

• Repetitive Motion

Jobs that require repetitive motion carry some of the highest risks of tendon disorders. These manual labor and work-related repetitive injuries can stem from operating machines, lifting heavy objects, typing, cleaning, and overhead lifting. They can also result from using objects and tools that repeatedly require twisting, pulling, clicking, cutting, pressing, and bending movements. These daily activities are often performed uninterrupted and lead to strain and injury.

• Sports And Exercise

Athletes are also at high risk of contracting a tendon disorder when participating in sports and exercise. Repetitive motions, injury, and overexertion during training can lead to overuse, strain, and inflammation of tendons. Common motions in sports like swimming, tennis, volleyball, and basketball include constant overhead arm motions, running, jumping, twisting, throwing, and swinging. These activities are prevalent in various sports and require a combination of agility, power, and coordination to perform effectively.

• Age

Tendons lose elasticity and strength during age progression while less collagen is produced, making them more vulnerable to injury. Age-related tendon disorders occur in individuals aged 40 and above.

Tendon disorders can affect anyone, regardless of their athletic background, and are primarily caused by repetitive motion, sports and exercise, and age. Being aware of these causes can help individuals take preventive measures and maintain the health of their tendons throughout their lives.

• Treatment Options 

Treatment options for tendon disorders depend on the severity of each condition and according to a doctor’s recommendation post-physical exam. Early detection and treatment can result in few treatment procedures and faster recovery with better outcomes.

• Rest And Reduced Activity

Most mild to moderate cases of tendon disorders can be treated by reducing physical, strenuous activity and prolonged rest that promotes healing. This recovery process should accompany using ice packs on the affected area and using compressions and elevation to ease swelling and inflammation.

• Pain Management

To ease the pain caused by tendon disorders, doctors may suggest over-the-counter pain relievers and nonsteroidal anti-inflammatory or NSAID medication such as aspirin, paracetamol, and ibuprofen. Steroid injections are administered by healthcare providers for moderate to severe pain and chronic conditions. Doctors insert the needle adjacent to the affected tendon and inject corticosteroid and anesthetic into the area.

• Physical Therapy

When significant limb weakness has occurred, physical therapy can help by re-strengthening the muscles and restoring tendon functionality. These include a range of motion exercises, manual therapy consisting of soft tissue massages and stretches, and modalities using ultrasound devices and electrical stimulation.

Support: Braces and splints can be attached and strapped to the affected area to limit movement, immobilize the injured tendons and provide further support and stability to aid the healing process. The support devices are worn for the duration of the recovery period, which can range from a few days to weeks.

Surgery: When all other treatment methods have proven ineffective alone, and there are significant tears, degeneration, and severe chronic damage to the tendons, then tendon repair surgery is the next best procedure. The minimally invasive surgery is performed by an orthopedic surgeon who makes a small incision over the affected area and sews the torn tendons together. Then the area is covered up to allow healing.

A variety of treatment options are available for tendon disorders, ranging from rest and reduced activity to surgery in more severe cases. It is essential to consult with a healthcare professional for a proper diagnosis and tailored treatment plan to ensure optimal recovery and prevent further complications.

Conclusion

Tendon disorders can happen anywhere in the body but commonly occur in joint areas such as the shoulder, elbow, wrist, knee, ankle, and foot. These injuries are caused by inflammation, damage, or degeneration of the tendons through overuse, repetitive motion, or aging.

Conservative treatments for tendon disorders include nonsurgical procedures such as rest, pain management, and using support devices. Surgery and physical therapy are treatment options that can remedy progressed stages of tendinopathy and recover the strength and functionality of torn and damaged tendons.