Tendinitis/overuse injuries

Tendonitis is inflammation of a tendon and usually occurs due to overuse. Tendons are bands of strong connective tissue that attach muscle to bone. The most common symptom of tendonitis is pain that is dull and aching, sharp and burning or radiating.

Recovery from tendonitis is often lengthy.

Your osteopath will work with you to determine the cause of your tendonitis and decide on a course of treatment.

Common sites of tendinopathy include the following:

  • Rotator cuff of the shoulder.
  • Insertion of the wrist extensors (lateral epicondylitis, tennis elbow) and flexors (medial epicondylitis) at the elbow.
  • Patellar and iliotibial band at the knee.
  • Insertion of the posterior tibial tendon in the leg (shin splints).
  • Achilles tendon at the heel.

The history in patients with tendonitis varies with the specific disorder, as follows:

  • Lateral epicondylitis (tennis elbow)- Pain at the lateral aspect of elbow is present and becomes worse with grasping and twisting[1] ; a history of playing racquet sports or typing, manual labor is common.
  • Medial epicondylitis (golfers elbow)- Medial epicondylitis is common in golfers, bowlers, and carpenters[1] ; pain is located at the medial aspect of the elbow.
  • Rotator cuff tendinopathy This is associated with a history of participating in overhead activities such as painting, swimming, and throwing sports; deep ache in shoulder and painful range of motion are typical symptoms.
  • Patellar tendinopathy also referred to as jumper’s knee, is associated with insidious onset of well-localised anterior knee pain; it is common in participants in jumping sports (e.g., basketball, volleyball, high jumping) and running[2] ; anatomy of the patellar tendon is shown in the illustration below; pain worsens when changing position from sitting to standing or when walking or running uphill is most commonly affected in jumper’s knee at the proximal patellar tendon
  • Iliotibial band syndrome – This is the most common overuse syndrome of the knee and manifests as lateral knee pain; the iliotibial band is depicted in the illustration below; this syndrome may be observed in cyclists, dancers, long-distance runners, football players, and military recruits; typically pain begins after completion of a run or several minutes into a run; pain is aggravated by running down hills, lengthening stride, or sitting for long periods of time with the knee bent.
  • Shin splints Pain is located at the anteromedial aspect of the lower leg. Shin splints have been associated with over pronation and with running on hard surfaces without proper footwear.
  • Achilles tendinopathy – Heel pain is evidence of Achilles tendinopathy; runners and other athletes have an increased incidence of Achilles tendinopathy; increased running distance, change in running surface, and poor footwear are associated factors.

Carpal Tunnel syndrome

Patients typically complain of an intermittent “pins-and-needles” paresthesia of the hand. Pain is generally worse at night than during the day. Patients may awaken with a burning pain or tingling that may be relieved with shaking their hands. Classic carpal tunnel syndrome (CTS) is associated with symptoms that affect at least two of the first through third digits; symptoms affecting the fourth and fifth digits, wrist pain, and radiation of pain proximal to the wrist may also occur, but classic CTS is not associated with symptoms on the palm or dorsum of the hand.

  • Symptoms are most often bilateral, insidious in onset, and progressive in nature.
  • With advanced nerve compression, an aching sensation is persistent and static and may radiate to the forearm and elbow.
  • Inquire with regard to repetitive strain risk, such as waitperson, assembly packing, computer keyboard work, playing a musical instrument, or craftwork.
  • Determine if any significant trauma has occurred.