What Is Tendonitis?

What causes tendonitis?

Tendonitis is inflammation of tendons—thick, flexible bands of tissue that connect muscles to bones. It is a type of tendinopathy, a broad term for tendon conditions that cause pain and swelling. Tendonitis can be long-term (chronic) or short-term (acute). 

“Tendonitis can occur almost anywhere a tendon connects bone to muscle,” said Christopher Larsen, MD, Catholic Health Orthopedic Surgeon. “However, it is most common in the ankles, elbows, knees, shoulders, hands, and wrists.”

He explained that overuse is the most common cause of tendonitis. “Most people develop tendonitis from repetitive movements necessary for their jobs, sports, other hobbies, or just everyday life,” he said.

Overuse stresses the tendons, which become less flexible and less able to tolerate stress over time and as we age. Tendonitis can happen at any age but is most common after age 40.

Other causes of tendonitis include:

• After an acute injury

• Effects of diabetes and rheumatoid arthritis

What are the common types of tendonitis?

Tendonitis is an umbrella term for several conditions. Some of the most common types are:

• Achilles tendonitis. Inflammation of the Achilles tendon, which connects your calf muscle to your heel.

• De Quervain’s tenosynovitis (or Gamer’s thumb). Swelling of the tendons that run along the thumb side of the wrist.

• Trigger finger (or stenosing tenosynovitis). Inflammation of the fingers' tendons can cause clicking and locking and pain in the palm.

• Golfer’s elbow (medial epicondylitis). Pain on the inner side of the elbow.

• Tennis elbow (lateral epicondylitis). Pain on the outer side of the elbow.

• Jumper’s knee. Inflammation of the patellar tendon, which connects the kneecap to the shin bone

• Rotator cuff tendonitis. Inflammation of the rotator cuff tendons causes pain in the shoulder.

What are the symptoms of tendonitis?

“With names like tennis elbow, golfer’s elbow, jumper’s knee and gamer’s thumb, a common misconception is that you have to play those sports or do those activities to experience symptoms of tendonitis,” said Dr. Larsen. “You do not. Tendonitis is super common and can impact anyone .”

The main symptom of tendonitis is pain, especially when using the body part that hurts. Other symptoms include redness, tenderness, swelling and warmth. Pain may worsen at night, and stiffness may occur in the morning. If left untreated, sometimes tendonitis can lead to tearing and even rupture of the affected tendon.

Call your physician if: 

• Tendonitis pain suddenly gets worse

• You cannot move your joint

• You have a fever or chills, which can indicate an infection

Is tendonitis the same as a muscle strain?

The symptoms of tendonitis can be similar to muscle strain; however, with tendonitis, you feel pain near where the muscle attaches to the bone. With a muscle strain, you feel pain in the muscle itself. 

How is tendonitis diagnosed?

To reach a diagnosis, your physician will review your medical history, evaluate your symptoms and conduct a physical exam. An imaging exam can sometimes confirm a tendonitis diagnosis.

“If you are experiencing pain, talk to your doctor so they can help figure out the diagnosis,” said Dr. Larsen. “The sooner you get a diagnosis, the sooner treatment can start, which can help to relieve discomfort and pain.”

How is tendonitis treated?

You can treat mild tendonitis at home using the RICE method. RICE stands for rest, ice, compression and elevation. Ice can help relieve pain and swelling. Wrapping the joint and lifting it above your heart can also reduce swelling. 

“Since tendonitis typically results from overuse, rest can help alleviate symptoms,” said Dr. Larsen. “However, not moving your joints can cause them to become stiff.”

He recommends gently moving the joint through its range of motion after a few days of rest to keep it flexible. Also, do not try to work through the pain, as that can make it worse. 

Call your doctor if your pain continues or escalates. They may recommend other treatment options such as:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen that can relieve pain

• Bracing to rest strained tendons

• Physical or occupational therapy to strengthen the muscles and tendons

• Steroid injections to reduce inflammation and pain

In severe cases of tendonitis, surgery may be necessary to remove the inflammation around the tendon, and sometimes, a tendon repair is necessary. 

Can I prevent tendonitis?

If you were diagnosed with tendonitis, check with your doctor when it is safe to return to normal activities to prevent tendonitis from returning. 

To prevent tendonitis, it is helpful to:

• Reduce repetitive motions by taking breaks or not doing the same activity for extended durations.

• Always warm up slowly before exercising or playing sports to prepare your muscles and tendons and reduce the risk of injury.

• Move your joints through a full range of motion after exercising or playing sports.

You can see a physical therapist or a sports medicine specialist who can help you increase your range of motion and prevent overuse that leads to tendonitis or other injuries.

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