Tendinitis
 
 

 
What exactly is a tendon?  Is it similar to a ligament?
 
Ligaments are strong, white, fibrous tissue that runs short distances from one bone to another bone.  

Tendons are a different type of strong, white, fibrous tissue.  It connects muscle to bone--usually over much longer distances than ligaments.  Tendons slide up and down within a sheath, much like a piston.  
 

What is tendinitis?
 
Tendonitis is a condition where a tendon is inflamed.
 
What is tendinosis?

Tendinosis occurs when the tendinitis occurs for long enough that it begins to degenerate, attenuate (get stretched out and poorly functional), and even develop deposits of abnormal calcification.  

What is tenosynovitis?

Tendinosynovitis is an inflammatory condition of the tendon and the lubricating fluid within the tendon's sheath.  This fluid helps diminish friction of the tendon's movement, so the tendon may slide within its sheath.  

 
Why would a tendon become inflamed?
 
Tendons can become inflamed for a variety of reasons.  You can see it with a sudden trauma, where the tendon is struck in some way, or severely stretched.  You can also get tendonitis from repetitive strain--, from a minor irritation that worsens from overuse.  Poor-fitting shoes and bone spurs can rub and irritate tendons, and certain conditions can cause crystal depositions within tendons that can act like sand in your shoe to irritate and inflame a tendon.  
 
Where do you get tendinitis?
 
Any tendon can become inflamed.  But in the foot we see tendonitis commonly in the Posterior Tibial Tendon (which supports the foot), and in the Achilles Tendon (which helps push you forward).  

For more specific information on this topic, you may visit our web pages on both Posterior Tibial Tendinitis and Achilles Tendinitis. 

 
What does tendinitis feel like?
 
It can be sharp and shooting or dull and aching.  It can feel like a grating sensation, or like your foot is creaking.  There's often limited range of motion and diminished strength. 
 
How do you treat tendinitis?
 
After you are properly examined, we will usually recommend a combination of the following treatments: 
  • Rest the affected tendon completely, whether by cast, splint, taping or other means, until the tendon has calmed down.
  • Apply ice for the first 2 days after the injury.  
  • From the 3rd day on,  apply moist heat.  
  • Use an anti-inflammatory medication, preferably prescription strength. 
  • Steroid injections should not be used, as they can weaken tendon.
  • Physiotherapy
  • Massage
  • Shoe changes and / or orthoses are used  to address any biomechanical abnormality responsible for the tendonitis.
  • Surgery can be indicated for ruptures, degeneration, misplaced tendons, tenosynovitis (inflammation and degeneration of the liquid within the tendon sheath), and for other rare reasons.

It's important to take care of your tendons, as ignoring tendon pain makes them weaken, which makes them more susceptible to a tear.

How long does it take a tendon to heal?

It depends on the severity of the injury and which tendon is injured.  For most tendons with proper treatment, the inflammation usually subsides within a week or two.  If the pain does not resolve, you need to return to your podiatrist.   But major tendons like the Posterior Tibial Tendon and Achilles Tendon can take much longer to heal. 

How can I prevent tendinitis?

You can't do much about sudden, unexpected injuries, but you can protect yourself against the gradual-onset cause by a few simple precautions:  
  • Build up a new exercise program gradually  
  • Perform proper stretching
  • Warm up and cool down before and after exercise
  • Choose proper shoes 

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www.FootDoc.ca

This website is operated by 
The Achilles Foot Health Centre
S. A. Schumacher, D.P.M., F.A.C.F.A.S., F.A.C.F.A.O.M.  
Dr. S. A. Schumacher, Podiatric Corporation  

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