Biceps tendonitis is an inflammation of the tendon of the main or long head of the biceps brachii muscle. The most common cause of inflammation is often excessive stress on the area during work or sports. Tendinitis can develop gradually from wear and tear, or the tendon can become damaged all at once from direct trauma. The tendon may also become inflamed in response to other underlying problems in the shoulder joint, such as a rotator cuff tear or impingement syndrome.
The biceps brachii muscle is located on the front surface of the shoulder between the shoulder and elbow joints. In the proximal part of the biceps muscle there are two tendons, the long and short heads of the biceps.
The main tendon of the long head of the biceps originates from the glenoid cavity of the scapula, then passes intraarticularly, then follows the bony groove of the humerus and distally passes into one of the muscular heads of the biceps muscle. The origin of the tendon is at the superior pole of the glenoid, where the tendon is closely connected to the glenoid labrum and is often damaged along with it (SLAP injury).
In the bony groove of the humerus, the biceps tendon is fixed by special transverse ligaments that keep it from dislocating during movements in the shoulder joint.
The main and main function of the biceps brachii muscle is to provide movement in the elbow joint. The tendon of the long head of the biceps muscle in the shoulder joint performs an important function as a stabilizer and depressor of the head of the humerus during movement.
The tendon itself consists of collagen strands, which are arranged in bundles parallel to each other. This structure determines the high tensile strength of the tendon. This means that the tendon can withstand the high loads that muscles create by pulling on one end and moving the bones that are attached to the opposite end of the tendon. The biceps muscle primarily provides flexion at the elbow joint and supination of the forearm.
Continuous and repetitive movements of the shoulder joint can cause wear and tear on the long head of the biceps tendon. Damaged tendon cells do not have enough time to repair themselves, resulting in inflammation. Inflammation of the biceps tendon (tendinitis) can often be found in patients involved in sports or work activities that require repeated overhead movements. For example, swimmers, tennis players or throwing athletes. Constant inflammation in the tendon leads to disruption of its structure and loss of strength. The outcome of tendon degeneration is its rupture.
Biceps tendinitis can occur from direct trauma, such as a fall on the top of the shoulder. There may be damage to the transverse ligament that holds the biceps tendon in the groove, resulting in instability of the tendon and its dislocation and subluxation from the groove.
Such increased mobility of the tendon leads to inflammation.
Biceps tendonitis sometimes occurs in response to other injuries to the internal structures of the shoulder joint: rotator cuff injury, impingement syndrome, shoulder instability.
Rotator cuff injuries cause pathological displacement of the humeral head upward and forward relative to the glenoid during movement, which ultimately leads to biceps tendon impingement and tendinitis.
With impingement syndrome, the biceps tendon is pinched between the acromion and the head of the humerus, triggering an inflammatory reaction in it.
Shoulder instability also causes tendonitis in the long head of the biceps tendon. When shoulder dislocations occur, the labrum is often damaged and becomes detached from the glenoid. Increased displacement of the humeral head within the joint damages the nearby biceps tendon and also leads to biceps tendonitis.
More rare causes of biceps tendonitis are malunions of head and surgical neck fractures, as well as osteoarthritis, which changes the anatomy of the intertubercular groove along which the tendon passes.
The outcome of such changes can be constant irritation of the tendon, osteophytes in arthrosis, or sharp bone fragments in fractures.
Long-term tendinitis and tendon degeneration can lead to rupture of the biceps tendon.
Patients usually report pain along the anterior surface of the shoulder, especially in the projection of the intertubercular groove. The pain may spread down the biceps muscle towards the elbow joint.
The pain intensifies when lifting weights and working above the head, is usually aching in nature and very often goes away with limited physical activity (rest). The pain may be accompanied by clicking if there is instability of the biceps tendon.
In the final stage of tendonitis, the biceps tendon is torn off. Patients hear a click, and deformation occurs in the shoulder area due to contraction of the biceps muscle towards the elbow joint.
Pain in the shoulder joint after a tendon rupture decreases sharply.
The diagnosis is established after collecting a detailed history, as well as based on the results of a clinical examination. During the examination, special clinical tests are performed that help differentiate (distinguish) one disease of the shoulder joint from another. Sometimes it is quite difficult to distinguish biceps tendonitis, for example, from impingement syndrome. In such cases, an MRI is performed. MRI is a highly informative and at the same time non-invasive examination method, which has recently been increasingly introduced into medical practice. A conventional X-ray examination for tendinitis of the biceps tendon is not very informative. X-rays can reveal bone changes, fractures, osteophytes, bone spurs, and calcium deposits in the tendon area. Soft tissues such as muscles, tendons, and ligaments are not visible on x-rays.
Arthroscopy can also be one of the methods for diagnosing and treating the shoulder joint. This is a fairly minimally invasive treatment method.
During arthroscopy, it is possible to look into the joint and see its internal structure. An arthroscope is a small optical device that is inserted into the joint through a puncture of the skin and allows you to diagnose and treat injuries and diseases of the biceps tendon, rotator cuff, and labrum.
Traditionally, biceps tendonitis is treated conservatively.
Treatment usually begins with limiting exercise, giving up sports or work that led to the disease. Anti-inflammatory medications help reduce pain and swelling. After the pain and swelling syndrome has decreased, the gradual development of movements in the joint begins. In rare cases, cortisone injections into the joint cavity can be used, which dramatically reduce joint pain. However, cortisone injections can in some cases further weaken the tendon and cause it to rupture. If the patient does not have concomitant pathology in the joint (SLAP injury, rotator cuff tear, impingement syndrome), conservative treatment of biceps tendonitis is most often successful.
Surgery is usually offered if conservative treatment fails after three months. In case of biceps tendon pathology, the following can be performed: acromioplasty, biceps tendon debridement, tendon tenodesis or tenotomy. The success of the operation is also facilitated by the correction of concomitant pathology of the joint, such as a rupture of the rotator cuff, damage to the labrum, SLAP injury, etc.
The most common procedure for biceps tendonitis is acromioplasty, especially when the underlying cause is impingement syndrome. This procedure involves removing bone growths (osteophytes) along the anterior edge of the acromion process.
As a result of the operation, the space between the acromion process and the head of the humerus increases. This space contains important structures of the shoulder joint, such as the biceps tendon and rotator cuff. Accordingly, the pressure on them decreases, and therefore the pain and swelling syndrome also regresses.
Also during the operation, inflamed tissue around the tendons is removed, which also helps reduce pain.
Today, acromioplasty is performed arthroscopically. This allows you to work in the joint cavity through the smallest possible skin punctures. With arthroscopy, damage to the soft tissue surrounding the joint is minimal, resulting in faster healing and recovery.
To perform acromioplasty, several small skin incisions up to 4 mm are made, through which an arthroscope and special mini-instruments are inserted into the subacromial space. The joint cavity is washed with solutions under pressure, and special devices are used to treat bone and soft tissue. During the operation, it is also possible to examine other parts of the joint and identify associated damage.
By debridement of the biceps tendon we mean its surgical treatment, for example, smoothing the edges when it is separated. After this, the friction of the tendon during movements in the joint decreases, and the pain syndrome decreases. Unfortunately, this procedure is not very effective and is not aimed at eliminating the cause of the disease.
If the biceps tendon has undergone significant degeneration or is highly unstable, tenodesis or tenotomy may be considered. Tenotomy is the cutting of the tendon from its insertion in the area of the scapula. Tenodesis is its cutting and fixation in a new place in the area of the proximal humerus.
During a tenotomy, the biceps tendon and biceps muscle contract toward the elbow joint, causing deformity in the shoulder area. Therefore, tenotomy is usually performed on older patients with a large build. In younger and more active patients, tenodesis is performed. With tenodesis, the relief of the shoulder muscles is not affected. Both of these operations lead to a sharp reduction in pain in the shoulder joint.
There are many methods of open tenodesis and tenotomy, the most common is the keyhole procedure, in which the biceps tendon is cut off and sutured proximally.
Bone channels are formed in the head of the humerus, resembling a “keyhole” in the lower narrow part of which the tendon is blocked during movements.
Special anchors and screws can be used to fix the tendon to the bone. At the present stage, the above operations can be performed using an arthroscope and combined with acromioplasty.
The advantage of arthroscopic tenodesis is the reduction of damage to the intact tissue surrounding the joint, which leads to faster healing and recovery.
After the operation, a special orthotic bandage is prescribed; most often, passive movements in the elbow joint are allowed immediately after the operation. However, heavy lifting with the operated arm is limited until one month after surgery. More aggressive rehabilitation may result in the tendon tearing away from its new attachment site and causing deformity in the shoulder muscles.
In our clinic, we widely use arthroscopy and other minimally invasive methods of treating shoulder joint pathologies. Operations are carried out on ultra-modern medical equipment using high-quality and proven consumables, fixtures and implants from major global manufacturers.
However, the result of the operation depends not only on the equipment and quality of the implants, but also on the skill and experience of the surgeon. The specialists of our clinic have extensive experience in treating injuries and diseases of this localization for many years.
A tendon is a hard tissue that connects muscles to bones. For example, the tendons that are on the back of your hand are an extension of the muscles in your forearm that move your fingers. Some (but not all) tendons are covered by a sheath called the synovium, or synovial (tendon) sheath. The vagina produces a certain amount of fatty fluid that fills the space between the tendon and the covering membrane. This fluid helps the tendon pull the bones attached to it freely and smoothly.
Tendinitis and tenosynovitis are tendon injuries. They can often occur together. To be more precise:
It is believed that inflammation of the tendons and tendon sheaths are not always the primary cause of tendon pain. The main cause is believed to be injury, repeated minor injuries or tendon ruptures. Initially, these factors cause inflammation of the tendon. These injuries can subsequently lead to damage (degeneration) of the tendon. Some doctors believe that tendonitis and tenosynovitis should actually be called tendinosis or tendinopathy.
These injuries usually occur when the tendons are moved excessively. For example, this can happen after long periods of exercise, or excessive movement of certain muscle groups during your work. Tenosynovitis usually occurs around the wrist in people who do a lot of writing, work in an assembly line, etc. This type of tendon inflammation is also known as repetitive strain injury (RSI).
However, in some cases, tendonitis or tenosynovitis occurs for no apparent reason due to overuse of the tendons. There are also other causes of tendinitis and tendovaginitis:
These problems are more common in middle-aged people and especially in athletes. They are also common among people whose jobs involve repetitive movements, such as writing, typing, or using a computer mouse.
Tendinitis usually occurs in the part of the tendon that attaches to the bone. The main symptoms are pain, laxity and sometimes swelling of the affected part of the tendon. Pain occurs when you move the affected area. The skin in this area may also feel warm. You may experience limited movement or weakness in the part of your body that is controlled by the affected tendons. The ligaments may become stiff. In some cases, this condition lasts only a few days and then goes away on its own. In other cases, if left untreated, the disease can last for weeks or even months.
This condition can happen to any tendon in your body. However, some parts are more prone to these problems. For example, the tendons around your wrist and hand are most commonly affected. Some types of tendonitis and tenosynovitis cause very characteristic symptoms and have their own name. For example:
International Classification of Diseases code: M65.4
It is also known as stenosing dorsal carpal ligamentitis, stenosing tenosynovitis, chronic tenosynovitis, and styloiditis. This disease affects the tendons responsible for straightening the thumb. A typical symptom is pain above the wrist at the base of the thumb, which is aggravated by further movements and relieved by relaxation and rest of the hand.
International Classification of Diseases code: M65.3
It most commonly affects the ring finger, resulting in the patient being unable to fully straighten that finger.
International Classification of Diseases code: M77.1
A characteristic symptom of this disease is pain on the outside of the elbow. This usually occurs due to excessive movement of the forearm muscles.
International Classification of Diseases code: M77.0
It is similar to tennis elbow, but the pain is felt on the inside of the elbow.
This affects the large tendons behind the leg, above the heel.
The rotator cuff is a group of four muscles that help lift and rotate the shoulder. The tendons of these muscles can sometimes become irritated due to excessive movement.
Diagnosis usually does not require any tests or x-rays of the affected area. The diagnosis of tendovaginitis and tendonitis can usually be made by a doctor during examination and palpation of the affected area. If an infection is suspected, a blood test may be needed to determine the cause of the infection. If the diagnosis is uncertain, the doctor may suggest an X-ray, ultrasound, or MRI of the affected area.
There is no best treatment for tendonitis and tenosynovitis. However, the following procedures can be suggested:
Other methods are also used to treat tendinitis and tenosynovitis These include:
There is no method to prevent tenosynovitis or tendinitis. However, below are suggestions to help prevent reoccurrence:
Translation of an article from patient.co.uk
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Tendinitis occurs when the tendon becomes inflamed; first, the vaginal tendon may become inflamed - tenosynovitis or tenosynovitis; the tendon bursa may also become inflamed - tenobursitis. When inflammation from the tendon spreads to the muscular system, then myotendinitis occurs. The inflammatory process spreads to the tendons of the heel, knee, shoulder, hip, elbow and thumb. Tendenitis is typical for both people and animals, most often affecting horses, rarely cattle. What are the symptoms, forms, causes of tendonitis?
The acute form can be aseptic and purulent. Chronic has the following types - fibrous, ossifying, and develops if salt is deposited in the tissues. The disease may be parasitic in nature.
1. If a person moves a lot and constantly.
2. In cases of microtrauma, if a sprain occurs, this often happens after playing sports.
3. Due to diseases of the skeletal and muscular system - arthritis, rheumatism, gout, etc.
4. If the tendon is not formed correctly and may weaken.
5. If a person has problems with posture.
Most often, the disease affects those who have characteristic physical activity.
1. Pain in the tendon when a person actively moves and touches the place. If a person stops moving, the pain goes away.
2. The inflamed area turns very red when it is touched when it is very warm.
3. The appearance of a peculiar crunch in the human tendon.
4. The affected area may swell.
The doctor will definitely examine the sore spot, check how the patient feels when moving or touching. It is also very important to pay attention to tendon swelling in time. But the main thing is not to confuse tendonitis with other pathological processes. With arthritis, the pain is constant, both at rest and during movement, and can spread over all joints. Pain with tendonitis is local and occurs only with movement.
If, with arthritis, a person stops performing both passive and active movements, then with an inflamed process in the tendon, the person refuses only active ones.
With arthritis, you can notice that the joint is convex because the inner layer of the joint capsules thickens; with tendinitis, an asymmetric process occurs because it is associated with the vaginal tendon.
After a person undergoes all the necessary examinations, no changes are detected; problems arise only if a person’s tendonitis is complicated by rheumatism or infection. The x-ray shows that calcifications are forming - salts are being adjusted, this is typical for the last stages of the disease. Using an x-ray, you can find out that the patient not only has tendonitis, but also bursitis and arthritis. Spurs are also often found in the heels, Achilles tendon and muscles on the sole.
Radiography will help to identify in time that tendonitis is associated with diseases such as avascular necrosis, and to learn about tuberosity on the tibia.
Computed tomography and magnetic resonance imaging are used to find out whether there is a rupture in the tendons or not, also about degenerative processes when urgent surgery is needed.
Additionally, when diagnosing tendonitis, ultrasound is used; with its help, you can find out about changes in the tendon structure, as well as about its contraction.
1. First of all, you need to give up all possible physical activity; the affected tendon should be in a complete state of rest.
2. For tendonitis, use cold, for tendovaginitis, use heat.
3. You may need additional equipment such as a cane, bandage, splint, braces, or orthopedic shoes.
4. Prescription of such physical procedures as therapy with a magnet, laser, ultrasound, ultraviolet radiation.
5. In case of a chronic process, mud and paraffin applications and the appointment of electrophoresis with the addition of lidase effectively help.
6. Drug therapy consists of the use of anti-inflammatory drugs, as well as drugs to relieve pain and antibacterial medications.
7. Application of injections with corticosteroids, they are given into the tendon that is inflamed and the area that surrounds it.
8. When the acute process is over, the doctor prescribes physical therapy, which necessarily includes stretching exercises and strengthening of the muscular system.
9. In cases of chronic tendonitis, massage is prescribed.
10. If tendonitis is purulent, you urgently need to open the tendon sheath and rid it of pus. Surgery is required if the blood vessels narrow due to tendonitis, if there is a pronounced degenerative process in the tendon, also if the tendon ruptures, and if the Osgood-Schlatter disease is established. In this case, it is necessary to excise the affected area and scar tissue. After the operation, an important stage is rehabilitation, which lasts up to 3 months. You can return to your old life only after four months.
With their help you can relieve pain and inflammation. To do this, the following recipes are recommended: adding curcumin to food. This infusion works well; it requires dissolving a teaspoon of ground sarsaparilla root and ginger in 250 ml of boiling water.
For tendonitis, traditional healers advise using walnut infusion with vodka.
1. Don’t forget to constantly perform special exercises that will help warm up your muscles and tendons.
2. Movements should be different, in no case monotonous.
3. Try to avoid physical activity and injury.
4. Rest in a timely manner.
Thus, a person may suspect he has tendonitis if he develops lameness, changes in his gait, intermittent pain appears, and crackling can be heard at the top of the thigh. The following forms of tendonitis can be distinguished: gluteal, temporal, tibial, knee, calcaneal. Treatment depends on the stage of development of the disease; the sooner it is detected, the easier it can be eliminated, so you should not endure unpleasant sensations, you need to immediately be examined and find out the reason for their occurrence.
Tendinitis (tendinosis) is a degenerative process in tendon tissue.
Tenosynovitis is an inflammation of the tendon that occurs in the area covered by the synovial membrane.
When an infectious agent enters or there are reactive changes, the synovial membrane begins to produce fluid - exudate or transudate.
Tendonitis and tendovaginitis can occur primarily or secondary, as complications of arthritis, bursitis and a number of other diseases.
Most often, tendon inflammation occurs as a result of injury. It is not necessary to have serious damage - microtraumas to tendons, muscles, connective tissue and blood vessels that occur during intense sports training or physical work are sufficient.
With normal rest, these changes disappear. During an abnormal process of training or work, damage accumulates (chronic injury), and inflammation - tendonitis - can occur in this area.
In the initial stages, as a result of intense overload, swelling of the connective tissue and splitting of collagen fibers, changes in the mucous membrane occur. These manifestations are most pronounced at the sites of tendon attachment to the bone. Subsequently, areas of necrosis with the deposition of calcium salts, mucous, fibrinoid or hyaline degeneration appear in them with the replacement of the central part of the tendon with a jelly-like mucous sediment (fatty degeneration).
Salt deposits usually occur in areas where tendon micro-tears previously occurred. Since they are solid formations, they can further injure surrounding tissues, contributing to the spread of the process.
With continued intense loads, the cartilage tissue between the tendon fibers degenerates, hardens, and bone growths appear - osteophytes, spines and bone spurs. Similar changes can often occur with rheumatoid, reactive and gouty arthritis.
With tendovaginitis, as a result of inflammation, the synovial membrane begins to produce fluid - exudate or transudate. The process of its production is called exudation or transudation, respectively. Transudate is released during aseptic processes (aseptic tenosynovitis), exudate - during infectious processes (infectious tenosynovitis).
Transudate is a non-inflammatory fluid that begins to be produced during aseptic inflammation due to impaired blood and lymph circulation, water-salt metabolism or increased permeability of vascular walls. It differs from exudate in its low protein concentration (no more than 2%). The formation of transudate can be a consequence, for example, of excessive physical exertion, after which tissue swelling occurs, followed by the production of fluid by the synovial membrane.
Aseptic tendovaginitis can be acute (acute crepitant) and chronic (chronic stenotic).
Exudate begins to be produced when an infectious agent is attached and is a protective mechanism. This is a cloudy liquid containing a large amount of protein and formed elements.
Depending on the predominance of various cellular elements, it can be: serous, purulent, hemorrhagic, fibrinous or mixed.
In acute infectious processes, neutrophilic leukocytes predominate in the exudate; in chronic infectious processes, monocytes and lymphocytes predominate; in allergic processes, eosinophils predominate. A breakthrough of exudate from the lesion may occur with the spread of inflammation to surrounding tissues. Thus, not only tenosynovitis can be a consequence of arthritis, but also vice versa.
A large accumulation of exudate or transudate can compress surrounding tissues, impairing their functions and causing pain. With proper and timely treatment, the liquid is completely absorbed, leaving no changes behind.
Depending on the nature of the course, the disease can be:
The following symptoms are typical for tendinitis and tendovaginitis:
Diagnosis begins with examination, identifying pain during active movements and palpation, swelling at the site of the tendon.
Laboratory tests do not reveal any changes, except in cases where tendinitis is associated with a rheumatoid or infectious process.
X-rays of the affected tendon often reveal no changes. They can occur in later stages, when calcifications have already appeared in the affected area. If the process began as a result of arthritis or bursitis, then the corresponding changes can be identified. Heel spurs are found in tendonitis and tendobursitis of the Achilles tendon or plantaris tendon. With tendonitis of the patellar tendon, there may be signs of aseptic necrosis of the tibial tuberosity (Osgood-Schlatter disease).
Often we have to resort to magnetic resonance imaging and computed tomography. It identifies areas of degenerative changes and tendon ruptures that require surgical intervention. These methods are not very informative for identifying stenosing tenosynovitis.
Ultrasound examination of the tendon is an additional method that can be used to detect tendon contraction or changes in its structure.
With tendinitis of the flexor and pronator muscles of the forearm (medial epicondylitis), the pronator teres, flexor carpi radialis and ulnaris and palmaris longus muscles are affected. The disease occurs as a result of chronic irritation of the medial epicondyle with reactive inflammation of the insertion of the flexor muscles.
The main cause of forearm tendonitis is excessive valgus deformity. Common in some sports (golf, golfer's elbow, tennis, baseball, table tennis, squash, gymnastics).
The most common causes of wrist extensor tendonitis (lateral epicondylitis) are participation in certain sports (tennis - “tennis elbow”, badminton, golf, table tennis and others). The pathogenesis is based on repeated injury to the extensor muscles, especially the extensor carpi radialis brevis. Fibrosis develops in response to chronic irritation. Other muscle groups may also be involved in the process: extensor digitorum communis, extensor radialis longus, and extensor carpi ulnaris.
X-rays of the affected joint usually do not reveal any changes. To clarify the nature and location of the lesion, magnetic resonance imaging is used.
A predisposing factor to the occurrence of temporal tendinitis is the habit of gnawing nuts, seeds or other hard foods. Also common causes of the disease can be malocclusion and other diseases of the teeth and jaws.
There are unilateral and bilateral cases of temporal tendinitis.
The pathology has the following manifestations:
Due to the nonspecific nature of its manifestations, temporal tendonitis is often mistaken for toothache, trigeminal or occipital neuralgia, or damage to the stylomandibular ligament (Ernest syndrome). Therefore, most often patients with temporal tendonitis turn to a dentist or neurologist.
Also, the symptoms of the disease can be attributed to the presence of arthrosis of the temporomandibular joint, sprain of its capsule or ligaments.
Temporal tendonitis symptoms improve when you stop eating solid foods. During treatment, talking should be limited as much as possible.
The following are used in the treatment of the disease:
In the absence of manifestations of arthrosis in the temporomandibular joints, treatment for temporal tendonitis usually takes 7-10 days.
Typically, crepitant tenosynovitis affects the synovial sheaths, which are located on the dorsum of the hand, less often the feet, and sometimes the intertubercular synovial sheaths of the biceps brachii muscle.
Often the process can become chronic.
The acute process most often occurs in the tendon sheaths of the dorsal surface of the hands and feet, less commonly in the flexor muscles of the fingers and synovial sheaths of the fingers. Purulent inflammation usually develops on the hand.
As purulent inflammation in the hand progresses, it can spread to the forearm. With purulent tendovaginitis of the little finger, ulnar tendobursitis may occur.
Most often it is localized in the sheaths of the extensor and flexor tendons of the fingers in the area of their retinaculum. The most typical is chronic tendovaginitis of the common synovial sheath of the flexor fingers located in the carpal canal.
Other forms of chronic tenosynovitis include de Quervain's disease and ulnar styloiditis .
De Quervain's disease is a stenosing tendovaginitis of the extensor brevis and abductor pollicis longus muscles, which is accompanied by thickening of the walls and narrowing of the cavity of the first canal of the dorsal carpal ligament.
Ulnar styloiditis is a stenosing tenosynovitis of the extensor carpi ulnaris, accompanied by narrowing of the VI canal of the dorsal carpal ligament.
Symptoms of the disease include pain and swelling in the area of the styloid process of the ulna.
This is patellar tendonitis, also known as jumper's knee.
X-rays are used to detect calcification within the tendon. For a more accurate diagnosis, magnetic resonance imaging is performed.
Treatment should include limiting physical activity on the tendon. Physiotherapeutic procedures (ultrasound, cold), drug therapy (non-steroidal anti-inflammatory drugs) are also used. Corticosteroid injections are contraindicated (as they may contribute to tendon rupture). Therapeutic gymnastics, which involves stretching the quadriceps muscles, eccentric strengthening exercises.
With significant damage in the center of the tendon, mucous degeneration develops and severe swelling occurs. At this stage, surgery is usually necessary. The degenerative portion of the tendon is excised, reconstructing the remaining tendon. In the patellar ligament, this degeneration occurs at the inferior pole of the patella or distally at the attachment to the tibial tuberosity.
The full name is Achilles and plantar tendonitis (talalgia).
The process can occur at the site of attachment of the quadriceps tendon to the upper pole of the patella. Unlike patellar tendinitis, this condition usually occurs in people who have put excessive stress on the tendon for a long time.
Symptoms are similar to those of patellar tendinitis. As a result of degenerative changes, the process often ends with tendon rupture.
This is a strain of the tibialis posterior tendon, located along the inside of the shin and inner ankle. Develops with prolonged overstrain of the lower leg muscles, pronation of the foot due to flat feet, tendon strain, and chronic microtrauma.
Treatment includes the use of orthopedic shoes with reinforced heels and arch support, and wearing arch supports.
Since the tibialis posterior muscle supports the arch of the foot, the disease can lead to the development of flat feet and cause excessive pronation of the foot, pain in the heels and arch of the foot, plantar fasciitis and heel spurs.
In the initial stages of tendinitis, conservative methods :
Surgical treatment methods used for severe degenerative changes in the tendons, stenosing tendonitis, the presence of Osgood-Schlatter disease, as well as tendon rupture. In this case, the damaged area and scar tissue are excised. After the operation, rehabilitation is carried out, which usually lasts 2-3 months. It includes therapeutic exercises with exercises for gradual stretching and strength development. Full physical training is allowed no earlier than after 3-4 months.
The basis of treatment for any tendonitis is avoidance of excessive physical stress on the tendon. In case of chronic and recurrent processes or the appearance of complications, you should think about changing your profession or choosing another sport.
The prognosis with timely and correct treatment is favorable. If physical restrictions are not observed, tendinitis can be complicated by tendon ruptures. With purulent tendovaginitis, persistent dysfunction of the hand or foot often remains.
Tendinitis is an inflammatory pathology that affects tendons in the human body. It is especially common among professional athletes and people whose work itself involves high physical activity.
With tendonitis, it is mainly those parts of the tendon that are located closest to the bone structures that are affected, but sometimes the entire tissue is affected. The main symptom of this inflammation is pain.
Tendon is a tissue consisting of collagen fibers. The main task of this tissue is to ensure the correct trajectory of movements, as well as maintaining joint mobility.
Doctors say intense physical activity is the main cause of the disease. However, the following etiological factors are often additionally identified:
All these factors do not necessarily lead to the fact that a particular person develops the disease, but they significantly increase the chances of encountering it.
Doctors distinguish two types of tendinitis – chronic and acute. In any of the cases, the symptoms of tendinitis do not develop immediately; it occurs gradually, without sudden jumps.
It all starts with the appearance of pain. Pain initially occurs only during severe physical exertion, which significantly exceeds the capabilities of one particular person.
Gradually, as the pathology progresses, unpleasant sensations begin to disturb even under standard loads. Eventually the patient will experience discomfort even at rest.
When examining the joint, the doctor will be able to pay attention to local swelling of the skin, its redness, and a rise in local temperature. In this case, a crepitating sound will be heard while driving. Sometimes, in order to hear it, it is not enough to rely only on hearing; you need a phonendoscope.
In addition to chronic and acute tendinitis, doctors distinguish a number of forms, depending on which joint is affected.
If a person experiences pain in the cheek area, which intensifies when chewing, and subsides when the jaw remains immobile, this is a reason to suspect a temporal type of disease. Discomfort is not always felt in the cheek area. Sometimes the pain radiates to the neck or to the head in general, without the ability to indicate a specific location.
When the heel tendon is damaged, the first thing the patient will complain about, in addition to discomfort, is limited mobility in the Achilles tendon area (there is no ability to lower the foot down or, on the contrary, pull it towards oneself). Upon examination, swelling of the articular area and local hyperthermia are possible. Surgical treatment is usually not required.
Tendinitis of the knee joint is quite common in medical practice. First of all, there is a type of pathology such as jumper's disease or patellofemoral tendinitis. In this case, the tendons that connect the patella and tibia are affected. As is clear from the informal name, it is mainly jumpers who suffer from the disease.
The patellar type of the disease occurs mainly in people whose age has passed the 40-year mark. During this period, degenerative processes begin in the tissues, causing the patellar ligaments to suffer.
With shoulder disease, patients usually complain of acute pain, which is especially disturbing when trying to make a sudden movement. The shoulder joint suffers if a person is forced to hold his arms above his head for a long time (for example, while painting a ceiling).
In medical practice, there are several types of lesions of the shoulder joint. This is explained by the fact that the joint has a complex structure, a state of many muscles and bones.
Most often, the inflammatory process develops in the periosteal muscle, but damage to other components is also possible. So, for example, if a patient complains of discomfort when trying to perform rotational movements in the shoulder, we are talking about a pathology of the teres minor and major muscles.
Calcific or, as it is also called, ossifying tendonitis is a disease that, in addition to the inflammatory process, is accompanied by the deposition of calcium salts in the tendon area. In this case, the shoulder joint is most often affected, but other joints of the human body can also be affected.
Interestingly, the disease is more correctly classified as tendovaginitis rather than simple tendonitis. This is explained by the fact that not only the tendon itself, but also the surrounding tissues are involved in the pathological process due to calcium salts. As a result, if the pain has passed, but the treatment of the disease has not been given enough attention, it will continue to progress, leading to rapid wear and tear of the joint.
Tendonitis of the gluteal muscle tendon is accompanied by dysfunction and gradual complete atrophy. Disturbances in the motor sphere gradually increase until the patient understands that he cannot change the horizontal position to any other.
Often the tendon in this area undergoes rupture, as indicated by an acute pain attack and a characteristic clicking sound.
Inflammatory processes in the posterior tibial muscle are most often a consequence of constant trauma to this area. It is mainly encountered by women over 30 years of age who play sports professionally, but men are not immune from the disease.
Damage to the biceps usually occurs in people who are forced to frequently swing their arms above their heads. For example, swimmers and tennis players suffer from it. This affects the biceps tendon, which provides attachment to the muscle to the shoulder joint.
The patient will first notice the appearance of pain at the moment when he tries to lift something heavy, since during this period the load on the muscle will be the highest.
Epicondylitis of the lateral or, as it is also called, external type is a disease characterized by damage to the tendons of the extensor muscles of the wrist.
If at first the patient is not bothered by practically anything except pain, then over time he will not be able to even lift the cup from the table to drink if treatment procedures are not started in a timely manner.
Epicondylitis of the medial or external type is the involvement of the flexor muscles of the forearm in the pathological process. This disease often affects golfers, squash and baseball players.
The symptoms of medial and lateral epicondylitis are not much different from each other, and therefore an MRI is often required to make a diagnosis.
De Quervain's disease is characterized by inflammatory processes in the tendons that, together with the muscles, provide abduction and flexion of the thumb.
A person suffering from de Quervain's disease will complain to the doctor of pain, and when trying to perform the Elkin test (placing the thumb with the index and little fingers) will encounter failure.
Many patients wonder which doctor treats tendinitis? Most often, the treating specialist is either a traumatologist or a therapist.
If necessary, a surgeon or sports medicine doctor may be involved in the case. If there is a suspicion of an active rheumatological process, then contact a rheumatologist.
Before you can figure out how to treat tendonitis, it is important to get a proper diagnosis. The following techniques will help with this:
Treatment of tendonitis in the initial stages is carried out using conservative techniques. First of all, rest and cold are recommended to relieve inflammation.
Various therapeutic procedures from the field of physiotherapy are used (for example, massage, UHF, electrophoresis, ultrasound, magnetic therapy, etc.). Non-steroidal anti-inflammatory drugs are actively used.
Orthopedic means include the use of splints, casting, crutches, and special shoes. If an infection is suspected, antibiotics are prescribed.
If the disease is severe, the patient is recommended to use glucocorticosteroids, which are injected directly into the area of the inflammatory process.
Treatment of advanced tendonitis, which is accompanied by vasoconstriction and active degenerative processes, is carried out promptly. In this case, the affected area of tissue is removed, and then local therapy is carried out, similar to that used for ligament rupture.
If pain that was previously passing has become constant after physical therapy and conservative treatment, surgery is also recommended.
It is important to remember that tendonitis is much more difficult to treat than it is prevented. To prevent damage to tendon tissue, the following preventive measures are recommended:
Basically, with tendinitis, the prognosis is favorable if the patient consults a doctor in time. With timely initiation of therapy, the likelihood of complications is minimal, and therefore it is recommended to consult a doctor with minimal manifestations of the disease.