The Truth About Tendonitis
ENS Marylou Dryer, MS3
Journalist, BodyTek PT
Tendonitis can be a common complaint of athletes and those who
do repetitive activities. It occurs when the tough, collagenous
connection between a muscle and a bone becomes irritated and inflamed.
Any joint can be involved resulting in injuries ranging from BlackBerry
thumb and Nintendonitis to Tennis elbow or Jumper’s knee.
Overuse is the most common cause, but an increased level of demand,
changes related to aging, and anatomical changes because of disease
or past injury can all contribute to development of this painful
condition.
Treatment of tendonitis is focused on allowing the affected site
to heal by limiting further injury. Because tendons are made up
of a complex mesh-like network of several types of collagen fibers,
it can take much longer for this tissue to heal than for other trauma-related
injuries. Replacement of damaged fibers can eventually renew the
tendon’s original strength, but this process takes several
weeks. Several steps can be taken to encourage this process and
reduce pain:
- Rest –remember that injury is most often related
to overuse. Limiting aggravating movements is essential. This
may mean taking a break from the activity that originally led
to the injury. Generally at least three weeks should be allowed
to initiate healing, with a gradual return to activity over an
addition three weeks.
- Ice –applying an ice pack to the area will help
to control inflammation and limit swelling.
- Medication –anti-inflammatory medications like
Motrin and Aleve work at a chemical level to limit inflammation
and allow healing. An additional benefit is that this will also
reduce pain associated with tendonitis.
- Alternative therapy –alternatives to medication
such as careful stretching and massage can improve blood flow
and ensure that the healing process does not result in reduced
flexibility over the joint.
- Invasive therapy – persistent cases may require
more invasive therapies that can be performed by your doctor.
Injections of corticosteroids directly into the site of tendonitis
that is refractory to less invasive therapy such as rest and medication
can often provide considerable relief. However this may need to
be repeated if the pain returns after several months. Specialized
surgeries may also be an option for some cases in which other
therapies have failed.
Prevention is the most efficient way to
avoid the pain of tendonitis. The following points illustrate
that it is possible to continue activity while avoiding undue
stress to a tendon.
Strengthening and physical therapy will condition the tendon
to handle greater demands and loads of work.
Ergonomically correct movements limit irritation which leads
to inflammation of tissues.
Taking breaks, varying workouts, and alternating repetitive
tasks limits the stress on a tendon.
Splints can provide protection to sites of chronic irritation
and limit the strain that a repetitive task may have on a
tendon.
Supplements that provide the elements which
serve as the building blocks of tendon fibers are very popular
and are a multi million dollar business in the United States
each year. Some of the most popular supplements that are used
to build cartilage and tendons are frequently prescribed for
pain associated with osteoarthritis, an inflammatory disease
of the cartilage between the bones at a joint. Glucosamine
and Chondroitin sulfate as well as Methylsulfonylmethane (MSM)
are advertised as respectively providing the specialized amino
sugars and sulfa groups that are used by the body to make
collagen fibers. Potassium and other ions are also touted
as being beneficial on the theory that certain electrolyte
compositions are ideal for the stronger collagen that generally
comes later in the healing process.
| However, because supplements are not regulated by the
FDA, there is little money in research and there is therefore
little evidence that any of these supplemental therapies
has any beneficial effect on prevention or healing. Also,
because the companies that produce supplements and other
unregulated products are not held to the standards of
approved medications, different brands and even different
lots from the same brand may contain varying amounts of
the active ingredient. |
|
| MSM, also known as Methyl sulfone, sulfonylbismethane,
and DMSO2 is an organic sulfur compound present
in small amounts in many foods and beverages. It
is also used as an industrial solvent to make pharmaceuticals,
agrochemicals, and paint. Remember when beginning
any medication to do your research, to use a trusted
brand, and to consult a physician. |
|
|
Cross-training may be a way for you to continue
activity involving major muscle groups while limiting strain
on irritated tendons as you allow them to heal. For example,
runners and cyclists with painful ankles and knees may benefit
from varying their routine with other sports such as swimming
and skating.
Keep in mind that pain at any joint can be the signal for
many processes in addition to tendonitis. For serious injury
or for pain that persists after rest, you should consult a
physician to be sure that you do not have another problem
that will require different or more urgent treatment.
References
American Association of
Orthapedic Surgeons –
http://orthoinfo.aaos.org/fact/thr_report.cfm?thread_id=219&topcategory=Knee
British Journal of Sports Medicine. 2004
Feb; 38(1):8-11; discussion 11
Healthtouch.com/bin/EContent_HT/showAllLfts.asp?lftname=ACR035&cid=HT
Journal of the American Medical Association.
2003 Nov; 290(19):2573-80
Orthopedics.about.com/cs/sportsmedicine/a/tendonitis_3.htm
Tendonitis.net
Wikipedia –
http://en.wikipedia.org/wiki/Methylsulfonylmethane
http://en.wikipedia.org/wiki/Glucosamine
http://en.wikipedia.org/wiki/Tendonitis
