Written by Leann Poston, M.D.
Tendinitis is an often preventable and painful injury. It is the way your body says, “You have overdone it.” Poor body mechanics, overuse injuries, or even a single forceful movement can damage or even tear a tendon or ligament. Tendinitis results from an injury in which the load repeatedly placed on the tendon exceed its capacity to handle the load—overuse results in tissue breakdown. Treating tendinitis starts with PRICE and then therapies to regain function. Healing tendons can be frustrating because the movements that resulted in tendinitis are probably the same movements you are most eager to recover.
Tendons are like stiff rubber bands that bind muscles to bones. Ligaments connect bones to bones. Tendons contain collagen fibers, water, and ground substances. The ground substance allows a tendon to stretch and then return to its original shape. This ability to stretch helps prevent torn tendons and ligaments. Many tendons are wrapped in a sheath called a synovial sheath. This sheath provides blood supply and decreases friction around the tendon.
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Tissues such as tendons and ligaments sacrifice blood supply to maximize tensile strength. If blood vessels run through a tendon, they would interrupt the bands of fibrous tissue forming tendons and ligaments, which would decrease the tendon’s strength, much like windows in a building decrease its ability to withstand tornado-like forces. A lack of blood supply inhibits the ability of tendons and ligaments to heal quickly after an injury.
Tendinitis results when a tendon becomes swollen and inflamed after an injury. The symptoms of tendinitis include the following:
Tendinitis can affect tendons all over the body, but the structural damage and methods of treating tendinitis are the same.
Steps for treating tendinitis include the following:
Step 1: Identify the cause.
If you do not know what caused the injury, it will be a challenge to prevent it from reoccurring. Without knowing the cause, the offending exercise may be continued, which will interfere with tendon healing processes.
Step 2: Decrease pain and swelling
Step 3: Restore the range of movement
Step 4: Strength training
Step 5: Neuromuscular control and balance
Step 6: Functional or sports specific training
According to SportsMD.com, a torn ligament or tendon such as an Achilles tendon tear requires surgical repair and replacement with at least 6-9 months of rehabilitation before you can return to competitive play.
Weekend warriors and other deconditioned athletes are at the greatest risk for a torn ligament or tendon. Preexisting tendon injuries, tendonitis, or previous steroid injections also increase risk. Tendon tears or ruptures are most likely to occur in areas of the tendon or ligament which have the lowest blood supply.
A torn ligament has many similarities to a torn tendon in both mechanisms of injury and treatment options. Both types of injuries start with PRICE to decrease inflammation, and both types of injuries have both medical and surgical options.
Imagine you are doing all the right things for treating your tendinitis, you have maximized the benefits of PRICE. You are fully invested in your exercise rehabilitation plan, but your tendon or ligament injury is just not healing fast enough for you.
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.
James Wyss, M. M., & Amrish Patel, M. P. (2013). Therapeutic Programs for Musculoskeletal Disorders. Demos Medical. https://zu.edu.jo/UploadFile/Library/E_Books/Files/LibraryFile_171033_57.pdf
Micheli, L. J. (2010). Encyclopedia of Sports Medicine. SAGE Publications, Inc. https://us.sagepub.com/en-us/nam/encyclopedia-of-sports-medicine/book230719