Tendons are highly dense bundles of tissue that connect from muscles on one end to bone on the other. When a muscle contracts, it transmits force into the tendon to create motion across a joint. Irritation or inflammation of a tendon is known as tendinitis and causes pain or tenderness outside the joint, commonly around your shoulders, elbows, wrists and heels. Tendinitis involves microscopic tearing of tissue often occurring from repetitive stress.
Progressive Damage
Since tendinitis is caused by minor wear and tear on the tendon, it is degenerative in nature. If it's left untreated, low-grade inflammation develops. This can lead to tissue fatigue, making the tendon more vulnerable to partial tearing or a rupture. A ruptured tendon is completely torn and requires surgery. Pressure over the tendon will usually produce pain or soreness.
Testing
A health care professional will test a tendon through resistance. This requires a strong force that provokes pain in the tendon. A patient may be asked to hold his elbow at 90 degrees, for example. The clinician then holds the elbow in one hand and tells the patient not to let him move the arm. With the other hand, the clinician pulls on the wrist while the patient resists movement. Pain would be felt in the biceps tendon.
Common Injuries
Repetitive movements such as computer keyboarding with poor posture can lead to tendinitis within the many tendons that flex the fingers. Swollen tendons can then compress the median nerve and lead to what is called carpal tunnel syndrome. Tennis elbow, formally called lateral epicondylitis, is caused by gripping rackets. The force of balls hitting the racket is transferred through the racket to the muscles and into the tendon on the outside of the elbow. This leads to fraying of the tendon, causing progressive irritation.
Ganglion Cysts
The American Academy of Orthopaedic Surgeons defines a ganglion cyst as a thick, clear, mucuslike fluid similar to the fluid found in the joint. No one knows what triggers the formation of a ganglion. Some tendons have a sheath around them, and the cysts can develop within the sheath. Often these growths are harmless, but they can become unsightly or painful, requiring surgery. Sometimes the fluid is drained -- a procedure called aspiration -- or is removed through an incision.
Solution
Untreated tendon pain can lead to more complications. Rest, ice and splinting to prevent excessive movement can help the tendon recover. Should pain persist, a physical therapist can work with a patient to teach proper posture and body mechanics. Severe tendon pain may require an anti-inflammatory injection of cortisone. Degeneration of an injured tendon will continue if not dealt with, so it's important to learn how to avoid re-injury.
