By Sandrine Bouchard, physiotherapy technologist

Tendonitis is a common injury mentioned by patients who seek physiotherapy. How to recognize it, what does it involve, and what should we do if we experience symptoms?  

Tendons

Tendons are fibrous and elastic bands of tissue that connect muscles to bones. Their main role is to allow movement by transmitting the forces generated by muscles to the bones. Tendons are often covered by a synovial sheath, whose inner walls secrete fluid that helps lubricate the tendon. 

Tendonitis or tendinopathy?

Tendonitis is the acute stage of tendon injury with signs of inflammation. This condition typically resolves within a short period (approximately 4 to 6 weeks).

Tenosynovitis represents the inflammation of the protective sheath surrounding the tendons (synovial sheath). This phenomenon is often associated with tendonitis.

When the pain persists beyond the inflammatory phase and continues over time, it is referred to as tendinopathy. This persistent condition shows more significant signs of long-term wear. With or without an inflammatory process, it is associated with changes in the tendon structure. As tendon fibers become weakened over time, they are more prone to tearing.

Causes

• Repetitive friction between the bone and the tendon (such as through sports or work).
• Excessive muscular strain (a shock, an intense effort, or a violent muscle contraction).
• Repeated vibrations (micro-trauma caused by sports or work).
• Poor posture or prolonged positions in the same stance.

Symptoms

• Pain during movement, contraction, or stretching of a muscle
• Pain at rest
• Joint limitations
• Local tenderness upon palpation
• Swelling, redness, and local warmth

Common Tendons Affected in the Upper Limb:

• Tendons of the shoulder (rotator cuff);
• Extensor tendons of the elbow (epicondylitis);
• Flexor tendons of the elbow (epitrochleitis);
• Tendons of the thumb (De Quervain’s);
• Flexor tendons of the fingers or wrist;
• Biceps tendon;

How to Prevent It?

• Warm up properly before physical activity (e.g., 5 to 10 minutes of cardiovascular activity like walking or cycling).
• Focus on good posture and quality movements during physical activity or repetitive tasks.
• Properly manage the intensity, volume, and frequency of efforts to be more effective and progress better.
• Vary your workouts and/or sports to avoid constantly stressing the same muscles and joints.
• Allow for rest periods to optimize recovery.

How to Treat It?

• Temporarily stop the movements that cause pain while keeping those you can still perform;
• Apply ice or heat;
• Gradually start moving again after a few days. A slight amount of pain is tolerable as long as it does not increase during or after the movement or effort.
• Specific exercises can help optimize tendon healing. Consulting with one of our physiotherapists will help you better understand the source of your pain, get exercises tailored to your condition, and prevent recurrence.