11 questions about tendonitis

1. What is tendonitis?
2. How do you recognize it?
3. What can you do yourself to reduce complaints?
4. What is the difference with bursitis?
5. Do you have to go to the doctor with tendon complaints?
6. What can the physiotherapist do?
7. Can you prevent tendonitis?
8. Will a tendonitis go away on its own?
9. Will such a tendon remain a weak spot?
10. What are the latest treatments?
11. And that fun colored tape, does that help?

1. What is tendonitis?

A tendon connects a muscle to a bone. If the tendon is overloaded, small tears can occur. You will then feel pain where the tendon attaches to the bone. A tendinopathy, as the condition is officially called, is usually not an actual inflammation but an irritation. ‘Tendon injury’ would therefore be more appropriate. Because a tendon has poor blood circulation by nature, it can take a long time before it is repaired. Tendon complaints are most common in the wrist, heel, shoulder, hip, knee and Achilles tendon. A classic example is the tennis elbow.

2. How do you recognize it?

The main symptoms of tendonitis are pain and irritation. Sometimes the area where the tendon sits is red and swollen, sometimes it feels stiff in the morning. In the initial stage, the pain only occurs after strenuous exercise and the symptoms subside within a few hours. In a subsequent stage, the tendon also hurts during normal activities, without being really loaded. Later still, the pain is constant and movement becomes more and more difficult and painful.

3. What can you do yourself to reduce complaints?

It is important to keep moving when you have a tendonitis, but do it at a lower level. Always use painkillers, preferably paracetamol. Suppose, for example, that you suffer from your heel, then you will (unconsciously) go wrong and you will maintain the complaint, as it were. If you take a painkiller, you can load and move the foot normally. This is beneficial for recovery from the injury. It is better not to take anti-inflammatories such as aspirin and ibuprofen. Because a tendon inflammation is often not a real inflammation, an irritated tendon does not respond well to these agents. Anti-inflammatory drugs are also harmful to the stomach. In case of doubt, consult your doctor.

4. What is the difference with bursitis?

A bursa is a fluid-filled cushion that sits between the tendon and the underlying bone, allowing the tendon to move without friction. It is often difficult to distinguish tendonitis from bursitis. Both usually arise acutely and cause severe pain. But with an ultrasound you can see the difference. This can be important for the treatment, because a bursitis – in contrast to a tendonitis – can respond well to an injection or tablets with anti-inflammatories.

5. Do you have to go to the doctor with tendon complaints?

If you have a tendonitis, it is best to wait and see how the pain develops. Keep moving, but avoid straining. If the complaints persist or if you have no idea how the complaints arose, it is better to seek help from your GP or a healthcare professional physiotherapist switch.

6. What can the physiotherapist do?

Massaging is not very useful. What can help are stretching exercises, so-called ‘eccentric training’. This probably helps because new blood vessels are formed thanks to the exercises, so that the tendon can recover faster. In addition, the physiotherapist can ‘friction’, whereby he presses very hard on the painful area. He breaks the tissue a bit by pushing. The body responds to this by repairing things. The irritation then immediately recovers ‘with it’. A physiotherapist can also do a physical examination to see exactly where the complaint comes from.

7. Can you prevent tendonitis?

As you get older, the risk of tendonitis increases. This is because the quality of the tendons decreases. The quality also decreases if you move little. Exercise is therefore the best way to reduce the risk of tendonitis. Sometimes moving is really not possible, for example because of a flu or surgery. That’s not a bad thing, but then slowly build up the movement again.

8. Will a tendonitis go away on its own?

Most of the time. Nevertheless, it is always wise to find out what caused the overload and to do something about it. It is also important to keep moving. Otherwise it can take months or even years before the complaints are completely gone.

9. Will such a tendon remain a weak spot?

The chance that an irritated tendon will cause problems again is much greater than with a ‘normal’ tendon. For example, walkers of the Nijmegen Four Days Marches who have had an Achilles tendon injury regularly experience such an injury. The chance of recurrence differs per tendon. It depends on how much you load the tendon and what is causing the overload.

10. What are the latest treatments?

At the moment, a lot of research is being done into methods to help a tendon inflammation recover faster. One of those methods is the shockwave technique, which is also used to crush kidney stones. The strong sound waves also appear to be able to destroy calcifications. These are often located in the tendons in the shoulder. Once the calcifications are gone, the tendons can recover. But whether it really helps; opinions are divided on that. The same goes for corticosteroid injections and platelets. These treatments are performed by the orthopedic surgeon or the sports doctor. The injections of corticosteroids are sometimes also administered by the general practitioner.

11. And colored tape, does that help?

Taping can help to reduce the symptoms if you are going to put stress on the injured tendon. Cure tape is increasingly being used for this. This is a colored tape that not only supports and reduces pain, but also improves blood circulation in the skin. It is important that the tape is applied correctly. That is quite difficult, but usually learnable. A physical therapist can show you how to do it a few times, after which you can probably apply it yourself.

Thanks to Irene Hendriks (sports doctor, head trainer sports medicine and medical manager at CWZ Sanasport).