Wednesday April 19, 2017
At London Doctors Clinic, we're seeing plenty of runners that are participating in the upcoming London Marathon, for last minute check-ups before the big day. One injury commonly seen amongst athletes is tendonitis - specifically in the ankles and knees of runners. We discuss the symptoms of this condition, and what can be done to get you back on your feet!
What Is Tendonitis?
Tendonitis (also spelt tendinitis) is the inflammation of a tendon - the strong band that attaches muscle to bone. Tendons cause the bones to move when the muscles contract, helping that part of the body to move as one. Tendon injuries frequently occur during high impact sports where large amounts of twisting, turning and jumping is necessary. Because of the short, sharp movements these sports require, the tendons can easily become inflamed, leading to pain. The tendons can develop microscopic tears or become irritated under heavy weights or repeated movements.
Rarely, tendonitis can be caused by infections or the use of certain medications.
Tendonitis: Which Tendons Are Usually Affected?
Tendonitis can occur in many different joints, particularly the:
The most common form of tendonitis affects supraspinatus - a muscle in the shoulder that forms part of the rotator cuff. Some of the other rotator cuff muscles may also be affected at their tendon attachment to the bone, although this is rarer. The shoulder is particularly affected by tendonitis caused by overuse, especially by people who have to perform movements where they are repeatedly lifting their arms (stacking boxes, playing tennis etc.). The pain caused by tendonitis tends to occur in the same shoulder as the dominant hand due to the majority of the weight going through the joint on the dominant side.
Other common form of tendonitis include tennis elbow (pain on the outside of the elbow joint), golfers elbow (pain on the inside of the elbow joint) and tendonitis affecting the knee, achilles tendon or wrist.
One well known form of tendonitis is tennis elbow!
- A dull, aching pain at rest
- Pain on movement of the joint
- Pain that gets worse with movement of the surrounding joint
- Weakness or stiffness in the area (which is worse in the morning)
- Swelling, heat or redness
- Lumps over the tendon
- The sensation of the tendon cracking or pulling uncomfortably on movement
To diagnose a tendon injury, your GP or private GP will want to know what you were doing when you first felt the pain; if anything makes it better or worse; if you’ve had a pain or symptoms like this before; what you normally use that joint for or if you’ve changed your routine or overworked the area recently. They may want to know what the pain feels like - for example, whether it stays in one place or spreads out or if there is any tingling/numbness/ weakness associated with it.
They should be able to diagnose tendonitis with a history and examination of the joint, but may also request several scans to rule out anything more sinister. On examination, they will be looking for redness, swelling, weakness and limited motion of the joint. Further scans may include X-rays to look for any bone damage or MRI scans to determine the extent of the tendon damage.
Your GP may stop you from taking certain medications to avoid making the tendonitis any wprse; these include drugs such as statins, and antibiotics such as ciprofloxacin. Some people may require blood tests to look for other causes of inflammation including gout and rheumatoid arthritis.
Symptoms of tendonitis can last for a few days or several weeks. If the tendon is continuously used or put under particular strain during recovery, the area may become irritated again and the symptoms last for longer.
You can treat the symptoms of tendonitis at home by resting the area, applying ice packs as necessary and treating the pain with over the counter pain relief. As the tendon heals, you can gradually go back to normal activities, but these should be introduced over time and with particular attention paid - it is advised to stop if the area becomes painful again. If your tendonitis occurs repeatedly or lasts for long periods of time, your GP may recommend you for physiotherapy.
Preventing tendonitis can be done in a variety of ways:
- Gradually increasing the level of exercise or strain you put on the tendon
- Being careful to warm up properly and cool down the muscles and tendons before exercise
- Making sure you wear the appropriate footwear for an activity
- Pay attention to your technique during sporting activities - a coach or personal trainer may be able to help you with this
- Avoiding repetitive movements (try spreading them out/ taking breaks)
- Stopping before you outdo your own physical capability
- Treating symptoms as they first appear
To prevent tendonitis, it is important to warm up and cool down properly. This can be done by stretching before and after a workout.
If you think you might have tweaked your tendon in the run-up to the big race, don't hesitate to pop in for a quick, short notice GP consultation at London Doctors Clinic, for an assessment and advice from one of our fully-qualified GP's (we usually have same day doctor appointments available!). Don't risk further injury by ignoring tell-tale symptoms, such as pain and swelling. Simply book into any of our nine GP surgeries located across London - it couldn't be easier!
By Katie Hodgkinson