A tendon is tough, fibrous tissue that connects a muscle to bone. Tendons transfer the energy generated by muscle contraction to bone, thereby producing movement. Overuse or an acute injury damages tendon tissues causing tendonitis. Repetitive use leads to most cases of tendonitis, which commonly develops in the tendons that insert near the elbow and shoulder. Symptoms of tendonitis usually abate with rest and prescribed exercises. Uncommonly, surgery may be required to accomplish tendon repair.
Focal Tenderness
Tenderness over the affected tendon proves a defining symptom of tendonitis. Tenderness over the front of the shoulder typically occurs with bicep tendonitis, notes the American Academy of Orthopaedic Surgeons. Pressing on the tissues at the top of the shoulder causes pain with rotator cuff tendonitis. Lying on the affected shoulder during sleep also commonly produces shoulder pain with rotator cuff tendonitis. Tenderness over the outer aspect of the elbow occurs with lateral epicondylitis, better known as tennis elbow. Medial epicondylitis, or golfer's elbow, causes tenderness over the inner aspect of the elbow. Aching pain often exists at rest in the affected tendons.
Movement Related Pain
Various movements of the arm produce sharp pain with tendonitis. The type of movement that elicits pain depends on the tendon affected. As noted by Dr. Thomas Joseph in a MedlinePlus entry, overhead movements such as grooming the hair or reaching for items overhead may provoke pain with rotator cuff or bicep tendonitis. Pushing and pulling motions such as using a rake or shovel, or mowing the lawn may also elicit pain. Bicep tendonitis pain may occur with any arm motion that involves bending the elbow to move the forearm toward the shoulder.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that twisting forearm and wrist motions frequently provoke pain with medial and lateral epicondylitis. Opening and closing jars, turning a doorknob and using a screwdriver often lead to stabbing pain in the affected tendon. With lateral epicondylitis, pulling the wrist back to raise the hand--as in making a "stop" gesture--triggers pain along the thumb side of the forearm. Bending the wrist toward the forearm provokes pain along the pinkie side of the forearm with medial epicondylitis.
Muscle Weakness
Tendonitis often leads to weakness of the muscle from which the tendon emanates. The American Academy of Orthopaedic Surgeons explains that bicep and shoulder tendonitis cause weakness in performing overhead tasks. Lifting items of significant weight overhead may prove challenging or impossible. Lateral epicondylitis often leads to a weak grip. Dropping items or an inability to open jars may occur. This symptom proves particularly troublesome as lateral epicondylitis usually affects the dominant arm. Weakness wth forcible twisting activities of the wrist such as tightening or loosening a screw can occur with medial or lateral epicondylitis.
References
- American Academy of Orthopaedic Surgeons: Tendonitis of the Long Head of the Biceps
- MayoClinic.com: Tennis Elbow, Symptoms
- "American Family Physician"; Common Overuse Tendon Problems: A Review and Recommendations for Treatment; John J. Wilson, M.D., Thomas M. Best, M.D., Ph.D.; September 2005
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: Bursitis and Tendonitis
- University of Virginia Health System: Shoulder Tendonitis
