The bones of the human body are attached to the muscles through tendons, fibrous structures that serve to move the bone. The function of the tendons is to transmit force and load between the muscle and the bone so that the joint can move thanks to the muscular contraction. Tendons are usually highly elastic elongated or cylindrical structures, formed mainly by collagen fibers. When a tendon becomes inflamed or irritated as a result of repeating the same movement over time or a sudden injury, tendinitis occurs.
Symptoms of tendonitis occur where the tendon attaches to the bone causing pain, mild swelling, increased tenderness, and stiffness, especially when moving the injured limb or joint. Shoulder, elbow and knee are usually the areas that tend to suffer from tendonitis, although it can also appear on the hip, ankles and wrists. "If tendinitis is not treated in time it can become chronic, the injured tissue entering a process of weakness called chronic tendinosis which, over time, can cause tendon rupture", explains Dr. Juan Muñoz Ortego, head of the Service of Rheumatology of the Teknon Medical Center.
Certain types of tendonitis are named after the sport that increases the risk of developing it, such as tennis elbow, which causes pain on the outside of the forearm when twisting or picking up something. However, when performing the opposite movement, the so-called golfer's elbow can appear.
Other types of tendonitis are named for the area they affect. Achilles or Achilles tendonitis, caused by subjecting that area of the foot to repetitive stress, causes pain above the heel when walking. Patellar tendinitis or patellar tendinitis occurs when the tendon that connects the kneecap to the tibia wears down and causes pain under the kneecap, especially when going up or down stairs. This tendonitis is also known as jumper's tendonitis, as it usually occurs in people who play sports that involve jumping. In supraspinatus or rotator cuff tendinitis, pain is reflected in the shoulder area when rotating it backwards. And gluteal tendinitis or trochanteritis affects the trochanteric area of the hip and makes it difficult to walk or sleep on the injured side.
People who perform activities that require continuous movement are more at risk of tendinitis. That is why it is very important to move correctly so as not to overload the tendons. Practicing any sport with inappropriate technique can cause muscle overload, as well as jobs that require repetitive movements such as assembly lines. "There are other causes of tendonitis that may be secondary to infectious processes or rheumatic diseases that should always be ruled out by a rheumatology specialist, if there has not been a clear history," says the rheumatologist.
When diagnosing tendinitis, a physical examination of the patient is usually sufficient, "although we usually perform a musculoskeletal ultrasound to visualize and explore the path of the tendon in real time and detect alterations in its structure. If there are doubts about the severity of the lesion, a nuclear magnetic resonance and an analysis with specific markers are requested, in case of suspecting infectious or rheumatic diseases", adds Dr. Muñoz Ortego.
Once tendinitis is diagnosed, the main goal of treatment is to relieve pain and reduce inflammation to prevent further damage to the tendon. The use of anti-inflammatories, as well as rest and rest may be enough for a recovery that, yes, may take time to be complete. These conventional treatments are gradually being replaced by other multidisciplinary techniques that are more effective and have fewer side effects, such as infiltrations of platelet-rich plasma (PRP) or growth factors, with great analgesic and anti-inflammatory effects. This treatment involves taking a blood sample and centrifuging it to separate the platelets and, once separated, the solution is injected into the irritated area of the tendon.
Advanced physiotherapy or joint functional osteopathy techniques also obtain good results in the treatment of tendonitis. "Finally, a work plan directed by physiotherapy specialists will allow good prevention and, therefore, avoid new injuries both in the workplace and in sports, in order to have a good quality of life without pain", says Dr. Juan Muñoz Ortego.
In addition, to reduce the possibility of suffering from tendinitis it is important to relax when doing physical activity, avoid those that require overexertion for the tendons and if you feel pain during exercise, stop and rest. It is also convenient to improve the technique when practicing sports, in addition to stretching before starting and at the end. At work, maintaining correct posture and making sure the chair, keyboard and table are at the right height for your height and arm length is essential, as this will protect your joints and tendons from overexertion.
