Tendon Injury (Tendinopathy)

Topic Overview

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The heel and elbow joints are common sites of tendon injuries. For more information about tendon injuries in these areas, see the topics Achilles Tendon Problems and Tennis Elbow.

This topic does not address severe tendon tears or ruptures. To help you assess a tendon injury, see the topic Shoulder Problems and Injuries, Elbow Injuries, Knee Problems and Injuries, Finger, Hand, and Wrist Injuries, or Toe, Foot, and Ankle Injuries.

What is a tendon injury?

Tendons are the tough fibers that connect muscle to bone. For example, see a picture of the Achilles tendon, which connects the calf muscle to the heel bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually it is the result of many tiny tears to the tendon that have happened over time.

Doctors may use different terms to describe a tendon injury. You may hear:

• Tendinitis. This actually means "inflammation of the tendon," but inflammation is rarely the cause of tendon pain.
• Tendinosis. This refers to tiny tears in the tissue in and around the tendon caused by overuse.

Most experts now use the term tendinopathy to include both inflammation and microtears. But many doctors may still use the term tendinitis to describe a tendon injury.

What causes a tendon injury?

Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or aging. Anyone can have a tendon injury, but people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon.

A tendon injury can happen suddenly or little by little. You are more likely to have a sudden injury if the tendon has been weakened over time.

What are the symptoms?

Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.

• The pain may get worse when you use the tendon.
• You may have more pain and stiffness during the night or when you get up in the morning.
• The area may be tender, red, warm, or swollen if there is inflammation.
• You may notice a crunchy sound or feeling when you use the tendon.

The symptoms of a tendon injury can be a lot like those caused by bursitis.

How is a tendon injury diagnosed?

To diagnose a tendon injury, a doctor will ask questions about your past health and your symptoms and will do a physical exam. If the injury is related to your use of a tool or sports equipment, the doctor may ask you to show how you use it.

If your symptoms are severe or do not improve with treatment, your doctor may want you to have a test, such as an X-ray, ultrasound, or MRI.

How is it treated?

In most cases, you can treat a tendon injury at home. To get the best results, start these steps right away:

• Rest the painful area, and avoid any activity that makes the pain worse.
• Apply ice or cold packs for 10 to 15 minutes at a time, as often as 2 times an hour, for the first 72 hours. Keep using ice as long as it helps.
• Take over-the-counter pain relievers such as ibuprofen or naproxen (NSAIDs) or acetaminophen if you need them.
• Do gentle range-of-motion exercises and stretching to prevent stiffness.

As soon as you are better, you can return to your activity, but take it easy for a while. Don't start at the same level as before your injury. Build back to your previous level slowly, and stop if it hurts. Warm up before you exercise, and do some gentle stretching afterward. After the activity, apply ice to prevent pain and swelling.

If these steps don't help, your doctor may suggest physical therapy. If the injury is severe or long-lasting, your doctor may have you use a splint, brace, or cast to hold the tendon still. See a picture of a night brace used for an Achilles tendon injury.

It may take weeks or months for a tendon injury to heal. Be patient, and stick with your treatment. If you start using the injured tendon too soon, it can lead to more damage and, over time, make the tendon more likely to tear or rupture.

To keep from hurting your tendon again, you may need to make some long-term changes to your activities.

• Try changing your activities or how you do them. For example, if running caused the injury, try swimming some days. If the way you use a tool is the problem, try switching hands or changing your grip.
• If exercise caused the problem, take lessons or ask a trainer or pro to check your technique.
• If your job caused the tendon injury, ask your human resource department if there are other ways to do your job.
• Always take time to warm up before and stretch after you exercise.

Frequently Asked Questions

Learning about tendinopathies:	What is a tendon injury? What causes a tendon injury? What are the symptoms? How can I prevent a tendon injury?
Being diagnosed:	How is a tendon injury diagnosed?
Getting treatment:	What is the treatment for a tendon injury? What can I do to treat a tendon injury at home?
Ongoing concerns:	How can I keep a tendon injury from coming back?

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Author:	Shannon Erstad, MBA/MPH	Last Updated: December 20, 2006
Medical Review:	Martin Gabica, MD - Family Medicine Nicola Maffulli, MD, PhD - Orthopedics
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