Tendinitis, also known informally as tendonitis, is a type of inflammation that occurs in the tendons, the sinewy, tough bands of fibrous connective tissue that anchors muscle to the bone. A version of tendinitis that occurs in the elbow is a serious condition that can affect your ability to use your hand. If the inflammation results in diminished strength, then physical therapy will be applied as a treatment.
Definition
Tendinitis is a broad classification of tendon problems that involve inflammation. It also includes a condition known as medial epicondylitis, or golfer's elbow, that occurs in the elbow region. Medial epicondylitis is not entirely endemic to golfers, despite the name, but a golf swing is certainly a common cause. Other repetitive motions and activities such as throwing, chopping wood, running a chainsaw and the continuous use of a hand tool may also cause medial epicondylitis. It is somewhat interchangeable with the term medial tendinitis. However, medial epicondylitis does not cause inflammation in all cases.
Anatomy
Golfer's elbow causes pain that begins on the medial epicondyle, which is a bone protrusion that forms the inside bump of the elbow. The wrist flexor -- the muscles of the forearms that pull the hand forward -- attach to one main tendon on the medial epicondyle. This tendon is called the common flexor tendon. Tendons are made up of strands of material known as collagen which are lined up in bundles next to each other. The collagen strands have high tensile strength and can therefore withstand a lot of pressure. A contraction of the wrist flexors pulls on the tendon, so treatment of medial epicondyle will focus on working the wrist flexors.
Time Frame
Strengthening the tendons through physical therapy treatment will take four to six weeks for a non-surgical injury. If surgery is needed, however, then it will take much longer -- potentially as long as four to six months -- and will require immediate rest until your arm is strong enough to withstand any kind of force incurred against it. Active therapy usually starts about two weeks after surgery.
Isometrics
The most basic exercises are simple isometrics. Isometric exercises are rather limited: the muscles don't change length, and the affected joint doesn't move. They're also not very effective at building strength. However, they do help the muscles rehabilitate and maintain strength after an injury or surgery. They are done by mimicking a pushing or pulling motion; for example, pushing a wall or holding a dumbbell in place with a slightly bent arm. You can also push against the hand of another person or have them push against your hand. Only the flexor tendon is targeted, so the isometric exercises can be few in number.
Active Strengthening
Soon after an injury -- or about six weeks after surgery -- active strengthening can begin. Your therapist should be the one to advise you on how to strengthen and stabilize the muscles, joints and tendons of your wrist, elbow and arm. However, exercises usually include wrist flexions/extensions with a dumbbell, finger extension with a rubber band and a rubber ball squeeze. Remember to use your wrist to lift the dumbbell; it is not an arm curl. As strength begins to return, you therapist may have you undertake more intense exercises such as advanced strength training and racquet or club sports.
