It is a condition, in which there is inflammation of a tendon. It is an overuse injury, caused by chronic overload of a tendon. Muscle imbalance, decreased flexibility, poor biomechanics, improper techniques and training errors, as well as chronic degenerative changes are contributing factors for tendonitis.
At the beginning of this condition pain is felt after activity only, following by pain at beginning and after activity, progressing to pain at beginning, during and after activity ending with pain with activities of daily living.
Tendonitis starts with microscoping tearing of tendon due to overloading, which results in inflammation. Whereas tendinosis is caused by degenerative changes with chronic overuse tendon injuries. For example, “golfers elbow”. There is no sign of inflammation in the tendon, but there is changes in collagen of tendon. As it progresses it may cause partial or complete tendon rupture. In chronic stage, there is chronic inflammation, adhesions and fibrosis present. Tendon can thicken and there is decreased range of motion and decreased strength.
Tendons most affected are: supraspinatus tendon, infraspinatus tendon, subscapularis tendon, Biceps tendon, common extensor tendon, common flexor tendon, abductor pollicis longus and extensor pollicis brevis tendon, patellar tendon and achilles tendon.
At first the inflammation is controlled through ice, rest and non-steroidal anti-inflammatory drugs. Following by stretching, strengthening and slow return to activity.
In acute stage, techniques to decrease swelling are used. Also, trigger point therapy is used on muscles, that refer pain to the affected area. The muscles that opposes action of affected muscles are treated to decrease tension. Tension in affected muscles is treated through Golgi tendon organ release technique on the unaffected tendon. Compensatory muscles are also treated for tension and trigger points.
In chronic stage the treatment can be more aggressive. Fascial techniques are used to decrease fascial restrictions. Trigger point therapy and techniques that decrease tension are used in affected and opposing muscles. Frictions technique is used on affected tendon to decrease adhesion in a tendon. M2T blade can be used as well to decrease the adhesion. Treatment is followed by applying ice.
Treatment frequency is three times per week for two to three weeks, then twice a week for one week and once a week at the end. Treatment length depends on the amount of time tendonitis has been present. If the treatment is started on onset of symptoms, it can take four weeks to resolve. However, if tendinitis has been left without treatment for long time it can take up to six months.