Tendon pain (tendinopathy) can occur from repeated movements, trauma, or certain inflammatory diseases. The most common involve the shoulder or the Achilles tendon.
What is tendon pain?
tendons are cords fixed on the parts of the skeleton which serve as “holds” to the muscles. Their bundle structure and their composition of collagen fibers make them very resistant. “However, they can be weakened and sometimes cause pain called “tendinopathies“, of which the tendonitis (which corresponds to pain in the tendon with inflammation)“, explains Dr. Sophie Bur, sports doctor and Physical Medicine and Rehabilitation Doctor. Tendon pain can affect all the tendons in the body. However, the most common tendinopathies are those that touch;
- shoulder (rotator cuff)
- The elbow (tendon solicited during wrist movements)
- Achilles tendon (at the back of the ankle)
- Knee (patellar tendon, quadriceps…)
What are the causes of tendon pain? What diseases?
The tendon may be damaged, with or without inflammation. We are talking about tendinopathy if there is no inflammation and of tendonitis when the tendon is inflamed. There are several causes of tendon pain. “Tendinopathy can result from excessive friction tendon, a overuse tendon due to repeated movements (at work, during physical activity or an activity of daily living such as gardening for example), ofdirect trauma (blow, shock). Some metabolic or rheumatic diseases can also cause tendon pain“, lists our interlocutor.
What are the symptoms of tendon pain?
Typical symptoms of tendinopathy are:
- a pain caused by certain movements or positions stressing the tendon in question
- sometimes signs of local inflammation (redness) visible when superficial
- a warmth to the touch
- a light swelling (like a small pocket) next to the tendon
The evolution of a tendinopathy is the crackeven in the most extreme cases, breaking.
What examinations to do during a tendinopathy?
“The diagnosis is above all clinical and is mentioned before 3 specific clinical signs : pain on palpation of the tendon, pain on stretching of the muscle and pain on contraction against resistance“, details the expert. Generally, hasno additional examination is necessary but sometimes you can ask for a ultrasound to confirm the diagnosis.
► In the majority of casesthe tendinopathies disappear with a relative rest (we do not recommend total immobilization but we recommend avoiding movements that hurt) and taking anti-inflammatory drugs either oral or locally applied (creams) to relieve pain. The establishment ofa splint or brace allows the joint to rest. The application of cold helps relieve pain.
► Then, sessions of physiotherapy (stretching, muscle strengthening) as well as home rehabilitation exercises are necessary. “The physiotherapist can also do deep transverse massages : it massages the tendon perpendicularly to stimulate cell regeneration“, describes our interlocutor.
► In case of failure of the treatments previously mentioned, it is possible to corticosteroid injections at the level of the envelope which surrounds the tendon (the bursa). “In the event of a crack in the tendon, one can have recourse to the PRP (for Plasma Rich in Platelets), a recent and effective technique for healing which consists of taking the patient’s blood, which is centrifuged in a special machine, and reinjecting part of the blood (the platelets) directly into the tendon. This is done under ultrasound to be as precise as possible.“, shares Sophie Bur.
► Ultimately, we can operate and do what we call tendon combinga technique to repair the tendon.
To avoid recurrences, it is necessary to understand why the tendinopathy has occurred and in general, to adopt simple lifestyle and dietary measures:
► Stay well hydrated throughout the day and especially before, during and after physical exertion.
► Have suitable sports equipment or modify it (tennis racket, trainers, etc.) if it is suspected of being responsible for the pain in the tendons.
► Fight against overweight, tobacco and alcohol
► Consider wearing insoles in case of foot tendinopathy
► Take a break of 5 to 10 minutes after each hour spent in the same position (at work for example)
► Learn the right gestures at work and optimize your workstation because some tendon pain can be linked to an occupational disease (tendinopathy in the shoulder or elbow, for example). Do not hesitate to discuss this with your occupational physician.
Thanks to Dr Sophie Bur, sports doctor and doctor of Physical Medicine and Rehabilitation, Pôle de MPR IURC Strasbourg