PREVENTION

Tendonitis Prevention

Prevention of this condition requires stretching the muscle on a regular basis and thereby lengthening the tendon connection. This will allow less pulling and tractioning on the tendon attachment to the bone. When tendonitis does occur, it is important to treat it immediately, and thereby prevent it from reaching a stage that is more severe.

If only I would've known this sooner

With proper care for the area, the pain in the tendon should lessen over three weeks, but it should be noted that the healing of the area continues and doesn't even peak until at least six weeks following the initial injury. This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together. Scar tissue will continue to form past six weeks in some cases and as long as a year in severe cases. After 6 months this condition is considered chronic and much more difficult to treat. The initial approach to treating tendonitis is to support and protect the tendons by bracing any areas of the tendon that are being pulled on during use. It is important to loosen up the tendon, lessen the pain, and minimize any inflammation.
This can be done topically if a pain reliever has the ability to penetrate the skin barrier and contains anti-inflammatory agents. A topical formula that contains natural menthol will not only relieve pain, but dilate the blood vessels. This allows for relief of the tendonitis, without causing any stiffening of the tissue. MSM, also known as Methyl Sulfonyl Methane is a natural supplement that is getting a lot of attention due to its role in tissue healing at a cellular level. It is a natural organic sulfur that comes from rain fall and is found naturally in the human body. It has been shown to have anti-inflammatory effects on the tissues. Ice can relieve inflammation, but will constrict the blood vessels and further stiffen the tendon. Cortisone injections can reduce inflammation, but unfortunately are very caustic and can cause a weakening of the tendon structure and a create more scar tissue.

After the scar tissue has begun to accumulate, it will be important to perform procedures which help break down the scar tissue in the tendon tissue, so as to let the tendon and muscle regain it's normal flexibility and lessen the chance of further injury. While exercise is appropriate for breaking down scar tissue once the area has healed, it may further irritate the area during the initial stages. Therefore, other methods that can be performed by your healthcare provider, such as ultrasound and massage, may be safely used to accomplish this early on in the injury. Ultrasound uses sound waves that vibrate a such a fast level, that it cannot be felt with normal use. Ultrasound will cause an increase in circulation to the tissue and soften the scar tissue to allow it to further break down. Ultrasound can also be used as phonophoresis to help topical pain and nutrient solutions reach further down into the tissues by transporting them with the sound waves. Light stretches may also be performed if they do not cause any further irritation to the area during the acute phase. During the sub-acute and chronic phases of Tendonitis, more aggressive stretches can be performed, however, it should be noted that stretches should focus on the muscle belly and not attempt to lengthen the affected tendon. Additionally, you should not feel any irritation in the tendon during these muscle stretches.

Quick Facts

Common Areas of Tendon inflammation
The most common tendon areas that become inflamed are the elbow, wrist, biceps, shoulder (including rotator cuff attachments), leg, knee (patellar), ankle, hip, and Achilles. Of course, tendonitis can will vary with each person, as it strikes the areas you use most.

Tendonitis Symptoms
Symptoms can vary from an achy pain and stiffness to the local area of the tendon, to a burning that surrounds the whole joint around the inflamed tendon. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiffer the following day.

Types of Tendonitis

Some common types of tendinitis include the following:
Rotator cuff tendinitis affects tennis players, swimmers, and anyone who frequently lifts their arms above the head and in a forward motion. This causes several shoulder tendons to rub together. Inflammation can set in and, if severe and untreated, may start to erode the tendons. Rotator cuff tendons hold the upper arm bone in the shoulder socket.
Achilles tendinitis involves the strongest tendon in the body, the one that connects the heel to the leg muscles. It's usually caused by running uphill or downhill, jumping, or engaging in sports that require sudden stopping and starting. Wearing shoes with either very soft-padded heels or very stiff soles, especially for someone whose ankles roll in, may also contribute to Achilles tendinitis.
Flexor digital tenosynovitis (trigger finger) may be seen in people with rheumatoid arthritis and diabetes. A protrusion or thickening of the tendon catches in the tendon sheath, causing the finger to bend and stick.
De Quervain's tenosynovitis (De Quervain's syndrome) affects the tendon sheaths extending from above the wrist to the thumb. The most common cause is excessive wringing of the wrist or other repetitive movements. In some cases, rheumatoid arthritis may be involved.

How Tendonitis Occurs

A tendon is the end part of a muscle that attaches the muscle to the bone. The normally very elastic and soft muscle tapers off at the end to form the much more dense and stiff tendon. While this density makes the tendons stronger, the lack of elasticity of the tendon and the constant pulling on its attachment to the bone with movement, makes it much more susceptible to a low level of tearing at a microscopic level. This tearing will produce the inflammation and irritation known as tendinitis. Often spelled tendonitis, either spelling is correct for this condition. Tendinitis is usually seen after excessive repetitive movement with which the tendon gradually becomes tighter until the fibers start to tear. For example, a person who plays tennis may over- use the muscles of the elbow through hitting the ball repetitively and cause tendonitis to the area.

Tendonitis

The most common tendon areas that become inflamed are the elbow, wrist, forearm, biceps, shoulder (including rotator cuff attachments), leg, knee (patellar), ankle, hip, and Achilles. Of course, tendonitis will vary with each person, as it strikes the areas you use most. For example, many rock climbers tend to develop tendonitis in their fingers and swimmers in their shoulders (a.k.a. swimmer's shoulder.)

15 and above

Tinea pedis or popularly known as athletes foot is a common a fungal infection of the skin of the footnormally found between the toescaused by parasitic fungi called trichophyton. This skin condition is considered common to people ages 15 and above. Although some symptoms may occur to children 12 years and below, experts say that these are not serious indications of athletes foot but skin allergy or any other skin condition.

You will face it, too

If you are an athlete, you will probably face tendonitis at some point during your playing days. If you're a regular human being, you'll most certainly face it. Really common areas that are affected include the wrist, the elbow (tennis or golfer's elbow), the shoulder (rotator cuff tendonitis), the hip, the knee (patellar tendonitis), the heel (Achilles tendonitis), and the ankle and foot.
When you break it down scientifically, you see that joints move by the power of muscles. Muscles attach to bones and joints by way of tendons. These tendons transfer the force from muscles across the joint and cause it to move. Tendonitis happens for a variety of reasons. When the normal smooth gliding motion of a tendon is impaired, it can become inflamed and movement in that joint becomes painful.
The most common cause of tendonitis -- by far -- is overuse. When you perform repetitious activities, increase the intensity level of an exercise program, or simply "overdo it," the tendon sometimes responds to the new level of demand by developing inflammation and thus, tendonitis.
Another common cause is due to age-related changes of the tendon. As the tendons age, they lose their elasticity and ability to glide. We are still doing research to better understand the causes of these changes, but hypothesize that the cause may lie in the fact that blood vessels supplying nutrition to the tendons change and decrease in effectiveness over time.
A tendon can also become inflamed or injured abruptly. An injury can range from a simple strain to a rupture or tear (this is generally when orthopedic surgeons such as myself are really needed to put the tendon back where it goes). Common tendons that can rupture include the rotator cuff, the biceps tendon, the patellar tendon, and the Achilles tendon.
Treatment of tendonitis tends to be conservative. Most physicians will recommend some simple treatments like rest, activity modification, bracing, anti-inflammatory medicine, and sometimes injections. Physical therapy and the appropriate rehab can also help you "mend" faster, as well as strengthen your muscles and improve flexibility to prevent recurrent flare-ups.

Overview

Tendonitis (also tenonitis or tendinitis) is an inflammation of a tendon. For example, patellar tendonitis (jumper's knee) is an inflammation of the patellar tendon, which connects the tibia to the patella.Recent research adds weight to a line of evidence suggesting that nitric oxide (NO) plays an important role in tendon healing (Xia et al, 2006). And inhibition of NO synthesis impairs tendon healing (Darmani et al, 2004). Such findings may lead to improved modes of treatment for this sometimes chronic condition. For example, NO is synthesized in the body from the amino acid arginine, supplementation of which boosts NO levels (UC Berkeley, Wellness Guide).
Standard treatment of tendon injuries is largely palliative. Non-steroidal anti-inflammatory drugs combined with rest and gradual return to exercise is a common therapy. However, some evidence suggests that tendonitis is not an inflammatory disorder and that anti-inflammatory drugs are not effective (Khan et al, 2002). Perhaps the most promising avenue of therapy is indicated in a line of research finding dramatic rates of recovery including complete remodeling of chronically damaged tendon tissue with eccentric loading exercise (see for example: Alfredson et al 1998; Mafi et al, 2001; Fahlstrom et al, 2003; Roos et al, 2004; Öhberg et al, 2004; Jonsson & Alfredson, 2005; Wilson & Best, 2005; Rees et al, 2006).

In this blog...

Tendonitis prevention is simple, much easier than treatment. In most cases tendonitis can be prevented simply by using your common sense. On this blog I've got a list of easy tendonitis prevention techniques. These techniques apply to work, sporting and leisure activities. I recommend you use some of the techniques mentioned on this page if you think you're at risk of developing tendonitis.

Preventing Tendonitis

These are some great tips that are easy to keep in mind, check them out!

Use proper form and posture
It's important that you use the proper form and posture during work and activities. For example, a tennis player should use proper form when playing a tennis stroke and have the correct racket size for his/her physique. In a job related example, a computer programmer must sit with correct posture and have a ergonomic working environment which includes the right height desk and chair, large monitor and suitable keyboard and mouse.

Ice stiff or sore joints after exercise
Placing ice on a joint or tendon helps reduce heat, swelling and inflammation. If you do apply ice, never apply the ice directly to the area, always wrap the ice in a towel and then apply.

Stay in good shape!
Staying in good shape is proberbly the best tendonitis prevention technique! Regular exercise (with the proper warm-ups and stretching of course) is recommended for individuals of any age. Regular exercise is not only good for your muscles and tendons but is an essential part of living a healthy life.
Preventing tendonitis is much better (and easier) than treating it. If you follow the prevention advice above you are limiting the possibility of developing tendonitis.

Preventing achilles tendonitis

Preventing achilles tendonitis is very simple. Your best defense against developing the condition is to warm up and stretch before activities and don't overdo it. Before you attempt any strenuous activity you should warm up for 5-10 minutes. Some light jogging or jumping on the spot will be enough.
During physical activity don't push yourself too hard. Know your limits. If you start feeling any pain in your achilles tendon stop the activity. Wearing the correct footwear is also important for preventing achilles tendonitis. Your shoes must be designed for your sport and have adequate heel support.

Athlete's foot at a glance

Athlete foot causes foot itching, burning, pain, and scaling.
Athlete foot is caused by a fungus and is treated with antifungal medications, many of which are available over-the- counter.
Keeping the feet dry by using cotton socks and breathable shoes can help prevent athletes foot.

Tinea Pedis

Athlete's foot is a skin infection in the foot caused by a fungus. The fungus that causes Athlete foot is called Trichophyton. When the feet, or other areas of the body, stay moist, warm and irritated, this fungus can thrive and infect the upper layer of the skin.

Athlete foot is caused by the ringworm fungus ("tinea" in medical jargon). Athlete foot is also called tinea pedis. The fungus that causes Athlete foot can be found on floors and in socks and clothing. The fungus can be spread from person to person by contact with these objects. However, without proper growing conditions (a warm, moist environment), the fungus will not infect the skin. Up to 70% of the population will have athletes foot at some time during their lives.

Short Overview of Athlete's Foot

Athlete's foot is a skin disease caused by a fungus, usually occurring between the toes.
The fungus most commonly attacks the feet because shoes create a warm, dark, and humid environment which encourages fungus growth.
The warmth and dampness of areas around swimming pools, showers, and locker rooms are also breeding grounds for fungi. Because the infection was common among athletes who used these facilities frequently, the term "athlete's foot" became popular.
Not all fungus conditions are athlete's foot. Other conditions, such as disturbances of the sweat mechanism, reaction to dyes or adhesives in shoes, eczema, and psoriasis, may mimic athlete's foot.

Oral treatment of athletes foot?

Oral treatment with griseofulvin was begun early in the 1950s. Because of the tendency to cause liver problems and to provoke aplastic anemia the drugs were used cautiously and sparingly. Over time it was found that those problems were due to the size of the crystal in the manufacturing process and microsize and now ultramicrosize crystals are available with few of the original side effects. Oral treatment provides long lasting mycologic cure.
If the fungal invader is not a dermatophyte but a yeast, other medications such as fluconazole may be used. Typically diflucan is used for candidal vaginal infections moniliasis but has been shown to be of benefit for those with cutaneous yeast infections as well. The most common of these infections occur in the web spaces (intertriginous) and at the base of the fingernail or toenail. The hall mark of these infections is a cherry red color surrounding the lesion and a yellow thick pus.

What are the symptoms of Athlete foot?

The symptoms of Athlete foot include itching and burning feet. The skin frequently peels and, in particularly severe cases, there may be some cracking, pain and bleeding as well.

When the skin is injured by the fungus, bacteria can also invade the skin. These bacteria can cause a bad smell. Bacterial infection of the skin and resulting inflammation is known as cellulitis. This is especially likely to occur in the elderly, individuals with diabetes, chronic leg swelling, or who have had veins removed (such as for heart bypass surgery), and patients with impaired immune systems.

Treatment

Treatment For Athlete's Foot

Fungicidal and fungistatic chemicals, used for athlete's foot treatment, frequently fail to contact the fungi in the horny layers of the skin. Topical or oral antifungal drugs are prescribed with growing frequency.
In mild cases of the infection it is important to keep the feet dry by dusting foot powder in shoes and hose. The feet should be bathed frequently and all areas around the toes dried thoroughly.

signs of athlete's foot

The signs of athlete's foot, singly or combined, are dry skin, itching, scaling, inflammation, and blisters. Blisters often lead to cracking of the skin. When blisters break, small raw areas of tissue are exposed, causing pain and swelling. Itching and burning may increase as the infection spreads.
Athlete's foot may spread to the soles of the feet and to the toenails. It can be spread to other parts of the body, notably the groin and underarms, by those who scratch the infection and then touch themselves elsewhere. The organisms causing athlete's foot may persist for long periods. Consequently, the infection may be spread by contaminated bed sheets or clothing to other parts of the body.

Growth environment of athlete's foot

Growth of the athlete's foot fungus is promoted by a dark, warm, moist environment such as that found inside shoes. The fungi persist for a long time in the environment, facilitating transmission of the disease in communal areas such as locker rooms and showers.

Athlete's foot can be a frustrating and annoying problem. Athelte's foot is causes by a fungus that lives in the warm, moist crevaces of the feet and toes. A few simple treatment measures can usually solve the problem of athlete's foot.
1) Athlete's Foot Cream
Over the counter creams work well to help in the treatment of athlete's foot. Usually these over the counter products, when used properly, and sufficient in athlete's foot treatment. Prescription treatments are usually not needed. Some of the most popular brand names include Lamisil and Lotrimin. Try these athlete's foot creams, but make sure you follow the instructions carefully.

2) Athlete's Foot Powders
A simple powder is an excellent treatment for athlete's foot. The fungus that causes athlete's foot likes to live in moist places. A powder will help keep the foot dry and prevent athlete's foot from becoming a problem. Many powder products are available to use in the treatment of athlete's foot--the brand is not particularly important.


3) Athletic Sandals
If you shower at a gym, locker room, or any other facility used by multiple people, wear a pair of athletic sandals in the shower. Locker room floors are the home of athlete's foot. They love steamy shower stalls, carpeted changing area, and just about anywhere else in the gym. Wear a pair of athletic sandals in the gym locker room at all times (including while showering!).

4) Athletic Socks
This is the simplest treatment of athlete's foot, and the most important in the prevention of athlete's foot. Get lots of pairs of socks, and change them often. Wear fresh socks to exercise, and change them immediately after exercise. Wash your socks after each use.