Tendon Trouble

Tendons are essential for every movement we make. Inflamed tendons, or tendinitis, can be very painful and can persist to become debilitating. Over time, this can sideline you from your hobbies and make everyday movement unpleasant. Here are simple strategies to help you avoid and treat tendinitis.

About tendons

Tendons are flexible yet tough, rigid chords that connect muscle to bone. Tendinopathy is the term now commonly used to describe overuse injuries in tendons. It includes a range of diagnoses involving injury to the tendon, such as tendinitis, peritendinitis and tendinosis.

Symptoms

Tendinitis can occur in any one of the body’s tendons; however, it is most common around the most-used joints. “The most common locations of tendinitis that I see are the shoulder, knee and heel in addition to various other tendons in the foot,” says Dr Teri Fisher, a sport medicine physician.

Tendinitis is characterised by a dull ache at the point where the tendon meets bone. At early onset, pain is felt during movement of the affected limb. As the disease progresses to a chronic state, pain is felt even at rest. There may also be tenderness and swelling.

Common types

Biceps tendinitis

Pain is located in the front of the shoulder and commonly caused by swimming, tennis, boxing, throwing and strength training.

Rotator cuff tendinitis

Inflamed tendons in the shoulder are one of the most common causes of pain and suffering. Rotator cuff tendinitis is often caused by swimming, tennis, boxing, strength training and improper exercise form.

Patellar tendinitis

The tendon that attaches the kneecap to the shin bone is affected by this form of tendinitis. It is common in jumping sports such as basketball and volleyball.

Achilles tendinitis

The Achilles tendon is the largest and strongest tendon in the body, and inflammation here is common among 30 to 50 year olds, with a higher prevalence among men. The inflamed tendon in the back of the calf and heel is commonly caused by basketball, tennis, soccer, walking and volleyball.

Lateral and medial epicondylitis

These are commonly known as tennis elbow and golfer’s elbow due to the repetitive motion in both of these sports, which leads to tendinitis in the elbow.

Causes

The main causes of tendinitis are repetition and/or overload of the tendon, followed by inadequate recovery time. Direct trauma to a tendon can also be an initiating cause. Persistent tendinitis (tendinosis) is believed to be the result of an incomplete healing process due to ongoing forces on the joint. Tissue degeneration is generally seen at this point.

Weekend warriors

“Tendinitis is often due to a rapid increase in frequency or intensity level of physical activity by someone who has not taken the time to train appropriately,” says Fisher. He also finds that people with tendinitis are relatively inflexible and believes having tight muscle groups are a risk factor for developing tendinitis. “An appropriate stretching and strengthening program is essential in the treatment of tendinitis,” he adds.

Tips for weekend warriors

• Increase physical activity levels gradually.
• Use proper form.
• Use appropriately fitting gear and equipment.
• Allow adequate recovery between bouts of activity.
• Strengthen and stretch muscles around each joint.

In the office

Office workers are especially prone to tendinitis in the elbows and wrists due to the repetitive movements of typing, using a computer mouse, handling paperwork and answering phone calls. This daily repetition eventually leads to the development of tendinitis.

Tips for office workers

• Use ergonomic office equipment.
• Decrease or eliminate repetitive motions.
• Take scheduled movement breaks throughout the day to allow overworked areas of the body to relax.
• Sit and stand with ideal postural alignment to avoid hazardous joint angles.

Tendons and ageing

As we get older, our tendons start to lose their elasticity due to age and normal wear and tear, making ageing adults at higher risk of developing chronic issues. With constant overuse, tendons may tear and cause scar tissue to develop. This scar tissue causes further inflammation and pain in the area.

Tips for ageing tendons

• Stay physically active to keep muscles and joints strong.
• Pay particular attention to maintaining good posture and muscle balance.
• Start new activities very slowly.

Healing tendons

Rest your joints

“Initially, stop using the affected joint if possible, until the pain has subsided,” says naturopath Allana Polo. She suggests an Epsom salt bath as a very simple yet effective way to help muscles relax.

Fisher suggests a splint or brace to assist in resting the joint from painful activities. This can also provide some symptomatic relief if pain is severe. “I will often advise that patients use ice for acutely painful tendinitis to reduce inflammation,” says Fisher. For patients with more chronic situations, he will advise heat to increase blood flow to the area and to promote tissue healing.

Goodbye inflammation

“My favourite anti-inflammatory herbs and spices include chilli peppers, basil, cinnamon and turmeric,” says Polo. Turmeric in particular has tremendous natural anti-inflammatory properties due to the active ingredient curcumin.

She also recommends avoiding inflammation-causing foods, which include anything white (processed white flour, white rice, white potatoes and white sugar). The nightshade family of vegetables can cause inflammation in the joints, so Polo recommends avoiding tomatoes, capsicums and eggplants if pain is very severe.

Including organic whole grains, as well as fatty acids from fish, salmon, walnuts, avocados and extra-virgin olive oil will automatically help lessen the pain. Include various colourful fruits and vegetables to provide further antioxidant protection.

Play smart with your tendons. A little rest, nutrition and careful stretching will keep them pain-free, healthy and performing well.

Supplements for tendinitis

Nourish your tendons

Naturopath Allana Polo recommends these supplements that have been shown to reduce tissue inflammation:

• flaxseed oil
• omega-3 fatty acids
• borage oil
• evening primrose oil

She also suggests taking adequate amounts of the antioxidants vitamin E, beta carotene, vitamin C and selenium, which are important components of pain control. Magnesium is another extremely helpful supplement, as chronic pain can often be seen in patients who have low magnesium levels.