The Basic Science of Tendons & Tendinitis
What are tendon inflammations?
Tendons are ligaments made of connective tissue that move the inter-articular surfaces relative to each other and attach muscles to bones.
How is there inflammation?
Joint disease can occur with or without tendon inflammation.
Terms that denote inflammation of the ligamentous apparatus:
- tendonitis - this includes tenosynovitis and tendovaginitis;
Tendinitis - inflammation of the ligament at the point of attachment to the bone or muscle-tendon junction, in most cases it is combined with inflammation of the tendon sheath or bursa.
With inflammation of only the tendon tissue, the disease is called tenosynovitis, with the process occurring in the tendon sheath - tendovaginitis.
Enthesitis - tendon attachment sites become inflamed.
If in tendinitis the most common lesions are inflammation of the ligaments of the upper shoulder girdle, then the typical localizations of enthesitis are the plantar region, the Achilles tendon, the places of muscle attachment to the ribs and vertebrae.
The etiology of diseases may be as follows:
- overload during active physical activity;
- diseases of a rheumatic nature;
- reactive inflammation;
- injecting an infection.
The disease can occur in acute and chronic form.
Common symptoms of inflammatory processes:
- pain, most severe during active movements and on palpation;
- hyperthermia and hyperemia in the joint area;
- crunch when moving in the joint.
The main causes of tendinitis:
- Increased or monotonous loads, in which physical influences are directed only to a certain group of tendons;
- Specific and non-specific infections, the introduction of Koch's bacillus, streptococci, staphylococci, pallidum spirochete and other pathogenic flora that is carried through the bloodstream.
- Purulent-inflammatory processes in the body: panaritium, osteomyelitis, furunculosis and the like.
- Chronic diseases: arthrosis, arthritis, rheumatoid arthritis, ankylosing spondylitis ...
Diagnostics and general principles of treatment
The clinical picture of the disease is detected during examination by palpation. A characteristic difference between tendinitis and arthrosis and arthritis is pain only when moving or pressing.
In laboratory studies with non-infectious inflammatory processes, leukocytosis is not observed.
Radiography records only diseases in a severe stage, when deposits of calcium salts are observed.
The presence of a tendon rupture or an area with incipient degenerative changes can be detected with magnetic resonance imaging.
Changes in the structure of the ligament tissue can be seen during ultrasound.
Treatment at the initial stage of tendinitis is carried out as follows:
- Restriction or complete elimination of physical activity.
- Cold compresses for tenditis and warming up for tendovaginitis.
- Immobilization with a fixation bandage, where possible.
- Unloading with the help of assistive devices: crutches, canes, splints, bandages, orthopedic shoes for inflammation of the knee and hip joints, injuries to the tendons of the foot.
In the therapy of tendinitis, physiotherapeutic treatment is used: magnetic and laser therapy, ultrasound effects. Electrophoresis with plasma, aloe extract and lidase, paraffin and mud applications have proven themselves well.
To treat infectious processes, antibacterial drugs are prescribed. For pain relief and relief of painful symptoms, non-steroidal anti-inflammatory drugs, corticosteroid injections are used. The drugs are often injected directly into the affected joint.
During purulent tendovaginitis, it is often necessary to pump out purulent exudate accumulating in the area of lesions.
Surgical intervention has to be resorted to if an acute inflammatory process provoked severe degenerative changes or narrowing of blood vessels. In the latter case, it is necessary to resect the affected tissue.
After the rehabilitation process is completed or an acute inflammatory condition has been removed, the patient is recommended to engage in physiotherapy exercises.
Features of tendinitis of various localization
With inflammation of the tendons of the hand, painful sensations arise when the thumb is extended and pulled to the side, while trying to connect the thumb and little finger. The tendon sheath of the long abductor muscle and the short extensor suffers. The disease was once called laundress disease .
Treatment of early inflammation of the hand tendon is a single injection of corticosteroids into the affected area.
Inflammation of the shoulder joint includes a whole group of diseases. The shoulder joint includes the clavicle, humerus and scapula.
Rotator cuff of the shoulder - this is the name of the set of ligaments that hold this part of the skeleton - attaches to each other the supraspinatus, infraspinatus, subscapularis and small circular muscle. Therefore, the pain syndrome is very pronounced. It manifests itself when the arm is raised and when it rotates.
Separately, biceps tendonitis is an inflammation of the tendon that attaches the biceps muscle to the shoulder.
Ulnar tendonitis is divided into 2 types - lateral, caused by inflammation of the extensor ligamentous apparatus - tennis player syndrome; and medial - golfer's elbow - flexor tendon inflammation. In the first form of the disease, pain occurs on the inside of the arm, in the second, pain and weakness are felt on the outside of the shoulder.
Symptoms of inflammation of the tendons of the hip joint include the following conditions:
- discomfort when abducting the leg and pain when increasing the range of motion;
- pain in the outer thigh with lesions of the abductor muscles;
- pain in inflammation of the tendon of the iliopsoas muscle can radiate to the lower abdomen, while being localized in the thigh area.
Knee tendon inflammation develops in 3 stage.
With tendinitis of the ligaments connecting the tibia and patella, the initial stage is not accompanied by strong painful sensations, pain appears only with increasing physical exertion.
As the disease progresses, pain occurs spasmodically, even with light loads. With a severe stage of the disease, soreness is observed even in a calm state.
Inflammation of the tendons of the foot combines a group of tendinitis affecting the tendon of the big toe, arch of the foot, inflammation of the Achilles tendon and the posterior tibial muscle.
If the ligamentous apparatus of the big toe is affected, severe pain occurs when trying to stand on a toe.
Inflammation of the posterior tibial muscle is characterized by severe pain in the inflamed joint with increasing load, contributes to the development of flat feet. Mobility is limited: running is difficult - it is impossible to bear the load on the socks.
Achilles tendonitis causes pain in the foot. Most often, the disease occurs in athletes or women who arethey wear heels and then abruptly switch to flat soles.
Treatment of inflammation of the Achilles tendon is complicated by the occurrence of heel spurs - osteophytes, they are located with a sharp edge to the foot, and cause severe pain when walking. In this case, surgery may be required.
Shock wave therapy has proven to be an effective method for eliminating the problem in the initial stage of the disease - a course of treatment up to 7 sessions.
Prevention of tendinitis
The risk of developing inflammatory diseases of the tendons will decrease if you consume curcumin daily as a seasoning - 0.5 g per day
The initial stage of the disease is stopped by tea made from equal shares of ginger and sarsaparilla roots - smilax. A teaspoon in a glass of boiling water.
Before training, be sure to warm up, gradually warming up the muscles.
It is advisable to avoid monotonous loads, change position, and gradually increase the intensity of physical efforts.
Walking in high heels is undesirable - shoes should be comfortable.
If you experience pain during flexion-extension of the joints, consult a doctor. In addition to the general principles of treatment, there is an individual approach to certain types of the disease.