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.
Tendons are the tough fibres that connect muscle to bone. For example, the Achilles tendon 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:
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.
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.
Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.
The symptoms of a tendon injury can be a lot like those caused by bursitis.
To diagnose a tendon injury, a doctor will ask questions about your past health and your symptoms and will do a physical examination. 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.
In most cases, you can treat a tendon injury at home. To get the best results, start these steps right away:
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 physiotherapy. If the injury is severe or long-lasting, your doctor may have you use a splint, brace, or cast to hold the tendon still.
It may take weeks or months for a tendon injury to heal. Be patient, and stay with your treatment. If you start using the injured tendon too soon, it can lead to more damage.
To keep from hurting your tendon again, you may need to make some long-term changes to your activities.
Learning about tendinopathies:
Symptoms of tendinopathy can include:
The joint areas most commonly affected by tendinopathy are the shoulder, elbow, wrist, hip, knee, and ankle.
Sometimes tendon pain is caused by inflammation around calcium crystals in or around the tendon (calcific tendinitis). The cause of the deposits often isn't known. These crystal deposits can be quite painful and can become a chronic problem.
Symptoms of tendinopathy may be similar to those of inflammation of the bursa (bursitis). For more information, see the topic Bursitis.
To diagnose a tendon injury (also known as tendinopathy), your doctor will review your medical history and daily activities and conduct a physical examination to check your overall health, areas of pain and tenderness, and range of motion and strength. Your examination may also include checking your nerve function (feeling and reflexes) and blood circulation (pulses). If your symptoms are related to use of a tool or sports equipment, your doctor may want you to demonstrate how you use it.
If your medical history and physical examination point to a tendon injury, you will probably not need more testing.
If your symptoms are severe or have not improved with treatment, more tests may be helpful. These may include:
Initial treatment for a tendon injury (tendinopathy) generally includes rest and pain relievers. Acetaminophen can reduce pain. Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce both the pain and inflammation you might have from a tendon injury. The goals of this early treatment are to:
If you are still having pain, stiffness, and weakness after initial treatment, your doctor may recommend some type of physiotherapy. Also, you may need to make long-term changes in the type of activities you do or how you do them to prevent your tendinopathy from returning. The goals of ongoing treatment are to:
Take the following steps to treat tendinopathies:
If these steps do not help to relieve pain, other treatment may be considered. Your doctor may:
Medical researchers continue to study new ways to treat tendon injuries. In separate small clinical trials, nitric oxide and glyceryl trinitrate, applied topically (to the skin), showed promise at relieving pain caused by tendon injury.1, 2 In another study, the pain caused by calcific tendinitis (calcium built up in the tendons) was relieved by directing ultrasonic, or shock, waves at the injured tendon (shock wave therapy).3 For more information, see the topic Calcium Deposits and Tendinitis (Calcific Tendinitis).
You can prevent a tendon injury (also known as tendinopathy) from developing or recurring by taking steps at home, work, and during activities to promote healing and protect your tendons.
Home treatment steps include:
To prevent tendon injuries from developing or from happening again:
See the following for ways to ease a specific joint problem:
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The Canadian Centre for Occupational Health and Safety (CCOHS) promotes a safe and healthy working environment by providing information and advice about occupational health and safety.
|Canadian Orthopaedic Foundation|
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- Paoloni J, et al. (2003). Topical nitric oxide application in the treatment of chronic extensor tendinosis at the elbow. American Journal of Sports Medicine, 31(6): 915–920.
- Paoloni J, et al. (2005). Topical glyceryl trinitrate application in the treatment of chronic supraspinatus tendinopathy. American Journal of Sports Medicine, 33(6): 806–813.
- Wang C-J, et al. (2003). Shock wave therapy for calcific tendinitis of the shoulder. American Journal of Sports Medicine, 31(3): 425–430.
- Hurt G, Baker CL (2003). Calcific tendinitis of the shoulder. Orthopedic Clinics of North America, 34(4): 567–575.
Other Works Consulted
- Deane K (2009). Bursitis, tendonitis, myofascial pain, and fibromyalgia section of The locomotor system. In RE Rakel, ET Bope, eds., Conn's Current Therapy 2009, pp. 994–998. Philadelphia: Saunders Elsevier.
- Klaiman MD, Fink K (2005). Upper extremity soft-tissue injuries (chapter introduction). In JA DeLisa et al., eds., Physical Medicine and Rehabilitation: Principles and Practice, 4th ed., vol. 1, pp. 829–832. Philadelphia: Lippincott Williams and Wilkins.
- McMahon PJ, Kaplan LD (2006). Sports medicine. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 163–220. New York: McGraw-Hill.
- Mercier LR (2008). The knee. In Practical Orthopedics, 6th ed, pp. 215–251. Philadelphia: Mosby Elsevier.
- Mercier LR (2008). The shoulder. In Practical Orthopedics, 6th ed, pp. 55–89. Philadelphia: Mosby Elsevier.
- Stovitz SD, Johnson RJ (2003). NSAIDs and musculoskeletal treatment: What is the clinical evidence? Physician and Sportsmedicine, 31(1): 35–52.
|Primary Medical Reviewer||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
|Primary Medical Reviewer||Andrew Swan, MD, CCFP, FCFP - Family Medicine|
|Specialist Medical Reviewer||Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma|
|Last Revised||November 10, 2011|
Last Revised: November 10, 2011
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