By: RehabWorks Intern Jessica Dowdy - UCF Senior - Athletic Training

1. Tendinitis: effective treatment
of an overuse injury
Jessica Dowdy
Athletic Training Student
University of Central Florida

3. o
What is a tendon?
• A band of connective fibrous tissue that connects
muscle to bone
• Ex: patellar tendon, biceps tendon, achilles tendon, etc.
o
What is inflammation?
• Reaction of a tendon from irritation, injury, or infection
• Characterized by pain, swelling, loss of function, and
warmth
• Redness also occurs but is unseen on the surface

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Tendinopathy: a painful condition of an
overuse injury in and/or around a tendon
• Tendinitis: inflammation of a tendon
• Tenosynovitis: inflammation of the sheath surrounding
a tendon
• Tendinosis: a chronic degeneration of a tendon without
the presence of inflammation, resulting in multiple
tears in the tendon

6. All tendons can be susceptible to tendinitis
o Commonly injured tendons:
o
• Patellar tendon
• Achilles tendon
• Biceps tendon (proximal)
• Rotator cuff tendons (supraspinatus, infraspinatus,
subscapularis, teres minor)

7. Biceps tendon
Achilles tendon
Patellar tendon

8. Subscapularis and Supraspinatus
Teres Minor and Infraspinatus

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One of two causes
1. Acute overuse- a tendon is under excessive,
prolonged stress not allowing the tendon to heal.
•
Ex: repetitive use
2. Chronic- when acute tendinitis is not treated properly
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•
Ex: tendinosis
Tears/Ruptures

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Cardinal signs of inflammation
• Redness/discoloration
• Pain or tenderness
• Swelling
• Warmth
• Loss of function
o
Pain or tenderness• Along tendon, commonly at joint
• That worsens with activity

11. o
RICE
• Rest
• Ice
• Compression
• Elevation
o
Brace
• Used to shorten lever arm of the tendon
• Typically used at knee and elbow

13. o
NSAIDs
• Non-steroidal anti-inflammatory drugs
• Aspirin
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)

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Acute rehabilitation focuses mostly on RICE
• You want to decrease inflammation as soon as possible
and try to rest the tendon so that it has time to heal
instead of exacerbating the injury
o
Chronic rehabilitation focuses on pain
management, strengthening, and stretching.
• Goal is to reverse the damage of being a chronic injury

15. o
Eccentric exercises are heavily used in the
rehabilitation of tendinopathies
• Eccentric contraction- muscle fibers elongate under
tension
• Concentric contraction- muscle fibers shorten under
tension

17. o
Stretching
o
Strengthening surrounding musculature
o
Cross friction massage
o
80% of patients that were treated solely with
rehabilitation incorporating eccentric exercises
reported complete pain relief

18. o
Injections• Corticosteroids- is a steroid hormone used to decrease
inflammation
• Autologous Whole Blood- uses a patient’s blood and
injects it into the injury site to provide blood and
platelets, since tendons tend to lack strong blood flow,
this helps promote healing
• Platelet-Rich Plasma (PRP)- taking the person’s blood
that has an above baseline of platelets and injecting into
the tendon

19. Corticosteroids- good for temporary relief, has
no long term affects
o PRP- great success rate if followed with
eccentric exercises
o
o PRP- 73% success rate to the 49% steroid at 12-month
follow up
o
Autologous Whole Blood- good results in
studies conducted however still not enough
information

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Surgery
• Tenotomies- cutting the tendon to help the tendon
•
•
•
•
lengthen so there’s not as much tension
Athroscopic clean up
Surgery- effective, try to avoid if possible due to longer
healing process from just having a surgery and then
needing rehabilitation to strengthen
Surgery should be LAST resort due to longer treatment
time
67% of patients who had open debridement reported
decrease in pain and increase of function.

21. Start Conservatively!
o Try NSAIDs, RICE, and rehabilitation since
other treatments will require this as well
o All individuals are different choose treatment
accordingly
o Corticosteroids are only effective in short term
pain reduction, try PRP instead since there are
better results.
o

23. o
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Skjong CC, Meininger AK, Ho S. Tendinopathy treament:
where is the evidence?. Clinic in Sports Medicine. 2012; 31.2:
329-350.
Houglum PA. Therapeutic exercise for musculoskeletal
injuries. Human Kinetics. 3rd ed. Champaign, IL: Perrin DH;
2010: 445-457.
Hak DJ, Sanchez A, Trobisch P. Quadriceps tendon injuries.
Orthopaedics. 2010; 33.1.