Tendonitis: Don't Be Fooled
Greg Stemkowski MS, PT, CSCS, PES
Procore Physical Therapy P.C.
Here's a riddle? What hurts in the morning with movement, feels better after a shower, almost doesn't hurt during the day except when lifting objects, and hurts at night? If you guessed tendonitis you're right! These are the signs of a very common condition that effects just about everybody at least once in their life. It can be caused by either trauma from an impact or more commonly through repeated movements. Poor posture, developed over many years resulting in muscle imbalances, can also cause tendonitis in either the upper extremity or the lower extremity. People at risk for this condition are athletes who participate in repetitive motion sports, such as tennis, golf, baseball, bowling, biking and people with occupations that require repeated tasks like painters, carpenters, office workers, and factory workers.
Tendonitis is an inflammatory condition that can occur anywhere a tendon passes over a bone like at the shoulder, elbow, and wrist or at the hip, knee, and ankle. Repeated movements of a joint cause the majority of tendonitis conditions. Add stress to these movements in the form of resistance or fatigue of the muscle and you increase your chances of developing this tenacious condition.
The tendon attaches muscle to bone and is designed to provide tensile strength to the joint. This is due to the parallel alignment of the tendons fibers, which allows the muscle to work efficiently against resistance. In a tendonitis condition the tendon becomes frayed and damaged causing the inflammatory process to initiate. During healing, the tendons fibers adhere in a crossed hatched fashion. This changes the mechanics of those fibers so when resistance is applied to the joint it causes pain and inflammation.
Tendonitis conditions hurt initially in the morning and feel better with movement or a hot shower because the muscle and tendon components tighten over night to protect against movement. Once movement occurs the muscle and tendon components loosen resulting in decreased pain. This gives people a false sense of security that "it will go away." However, because tendonitis is an inflammatory condition it can easily become progressive. It may not hurt much now, but an aggressive day at work or an enduring practice on the field or court can make it worse especially if the individual has the mentality of "no pain, no gain" or "work through the pain." If this mentality persists, the pain will become more intense and eventually lead to reduced function, reduced productivity, and decreased performance. It can get to the point where a person can't move without pain and they sit wondering how they got into this condition.
Do yourself a favor don't wait until it is too late and don't work through the pain. The earlier tendonitis is diagnosed the easier it is to treat. If you suspect a tendonitis condition see an orthopedist to get a proper diagnosis and see a physical therapist to develop the proper treatment plan.