Understanding Tendinitis -- Diagnosis and Treatment
How Do I Know if I Have Tendinitis?
If you have the symptoms of tendinitis, your doctor may order X-rays and bone scans to rule out bone damage. Typically, however, tendinitis is diagnosed by physical examination alone. MRI scans can help determine the severity of damage to a tendon, but are usually unnecessary for newly diagnosed cases of tendinitis. Your doctor can also assess whether you have similar problems such as bursitis (inflammation of the fluid "cushion" surrounding the joints).
What Are the Treatments for Tendinitis?
The goals of treatment for tendinitis are to restore movement to the joint without pain and to maintain strength in surrounding muscles while giving the tissues time to heal. Adequate rest is crucial. Returning too soon to the activity that caused the injury can lead to chronic tendinitis or torn tendons.
As an immediate treatment for tendinitis, doctors and physical therapists recommend the RICE program: rest, ice, compression, and elevation of the injured tendon. They may also suggest aspirin, ibuprofen, or other anti-inflammatory drugs to help inflammation and pain. Ultrasound and whirlpool treatments are useful for relaxing muscles and tendons, improving circulation, and promoting healing. Occasionally, your doctor may discuss injecting corticosteroids (a stronger anti-inflammatory drug) around the tendon.
A physical therapist can propose an exercise plan that rests the tendon while strengthening nearby muscle groups and maintaining overall muscle tone. Only gradually will you begin to exercise the tendon itself. Your program may also include "eccentric" exercises, in which you gradually strengthen the muscle while stretching, stopping at the first sign of pain. You may also work into easy stretching exercises, done several times a day.
Surgery may be necessary to release or repair the involved tendon in chronic cases that don't respond to other interventions.
How Can I Prevent Tendinitis?
Include warm-up and cool-down exercises and stretches in your exercise routine. As a general rule, a good warm-up is five minutes for every 30 minutes of planned exercise. So, one hour on the treadmill or elliptical trainer should be preceded by 10 minutes of warm-up. Vary your exercises and gently stretch all the muscles and tendons you are planning to exercise.
Overly ambitious exercise in an attempt to lose weight rapidly also can lead to tendinitis.