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Overview

The tendons are thick, fibrous cords of tissue that connect muscles to the bones of the body. When these tendons are exposed to repetitive movements or minor trauma and major impacts, they become irritated and inflamed and this is referred to as tendinitis.

If tendinitis becomes a recurrent or persistent problem, then this is called chronic tendinitis. The most affected areas of the body tend to be the shoulders, elbows, ankles, and feet. The reason for this is because these are the parts of the body that are constantly being used and because they typically aren't areas that are rested during the day. 

Causes

Chronic tendinitis may affect tendons in various parts of the body and the reasons why this may occur are as follows:

  • Elderly individuals are at an increased risk of developing this condition as their tendons become harder and more brittle as their age advances.
  • Recurrent injuries lead to scar formation at the site of the damage of the tendons and this results in repeated inflammation.
  • Repetitive use of the tendons by athletes such as golfers and baseball players leads to an increased chance of developing recurrent and persistent tendinitis.
  • Patients with diabetes are more prone to developing chronic tendinitis. The reason why is unclear, but it is thought that decreased blood supply to the tendons as a result of vessel damage by diabetes may lead to delayed healing of the tissue structure.
  • Conversely, sedentary individual may experience this condition because they don't use their tendons as often and sudden movements can lead to inflammation of these tendons. 

Management

Chronic tendonitis can cause mild to severe pain and the earlier the condition is diagnosed and managed, the better the outcome for the affected individual as the risk of developing complications such as a tear or rupture of the tendon is reduced.

Treatment and management options for chronic tendinitis include:

  • Resting the affected joint by discontinuing activities that cause pain.
  • Using oral or topical non-steroidal anti-inflammatory medications such as ibuprofen, naproxen, or diclofenac to reduce pain and inflammation.
  • Applying ice packs or cold compresses over the affected area also helps to reduce swelling, especially when there's acute exacerbation of the problem. Applying warm compresses to chronic problems can help to promote blood flow to the area to facilitate faster healing of the injured tissue.
  • Stretching the muscles that are to be used for the physical activity can help the tendons loosen up somewhat to prevent them from becoming injured when sudden movements are made.
  • Steroid medications and local anesthetic agents may be injected into the affected joint to help reduce inflammation and if the pain is severe. 
  • If these conservative therapies are ineffective, then surgical intervention in the form of removing scar tissue from the damaged tendon or repairing torn or ruptured tendons may be warranted. 

Avoiding chronic tendonitis 

Ways to avoid developing or aggravating chronic tendonitis includes:

  • Changing physical routines by incorporating low impact exercises.
  • Conditioning the areas of use by starting at a low intensity and slowly increasing physical exertion.
  • Stopping activities when the pain starts or gets worse.
  • Athletes may try recording their techniques and the way they move when performing physical activities so that problematic movements may be spotted and modified to prevent tendon injuries.

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