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A guide to tendonitis: causes, symptoms and treatments

17/06/20243 min read

Laura Harcourt

Written byLaura Harcourt

andrew_chambler

Reviewed byAndrew Chambler

Female hiker walking along sea front. Wearing blue backpack and rain coat

Summary

1What are the causes of tendonitis?

In most cases, tendonitis is caused by repetitive movements or repetitive types of exercise, like running, jumping or throwing, or poor posture...

2Tendonitis symptoms

The main symptoms include: pain in a tendon (just outside the joint) that gets worse with movement, stiffness when moving the joint...

3How to treat tendonitis

One of the best places to start is using the ‘RICE’ protocol, which stands for rest, ice, compression and elevation...

Jump to section
Whether you're a keen sportsperson, spend a lot of time at your desk or enjoy long walks, tendonitis can affect anyone who makes repetitive movements on a day-to-day basis. So what can you do to avoid it?

With our helpful advice and self-care tips, we’ll teach you all you need to know. From what it is to how it’s treated, join us as we learn more about tendonitis.

What is tendonitis?

In simple terms, ‘tendonitis’ describes the inflammation (swelling) of a tendon – a strong band of tissue that connects muscles to bones in your joints.1,2 

Your elbows, knees, shoulders, hips, Achilles tendons (at the back of your ankles) and base of your thumb are some of the most common areas to be affected, but you can experience tendonitis in any joint within your body.1-3
Injury from workout concept : The asian man use hands hold on his ankle while running on road in the park. Focus on ankle.

What are the causes of tendonitis?

In most cases, tendonitis is caused by repetitive movements or repetitive types of exercise, like running, jumping or throwing, or maintaining a poor posture.1,3 
These types of injuries are known as repetitive strain injuries (RSI).4

Sudden, sharp movements can also be a cause of tendonitis, but this is less common. If this is the case, you might hear a popping or snapping sound when your pain first started, which can be a sign that your tendon has either ruptured or torn.1,5

Tendonitis symptoms

There are several symptoms associated with tendonitis. The main symptoms include:1,2,5,6 
  • pain in a tendon (just outside the joint) that gets worse with movement
  • stiffness or difficulty moving the joint
  • a grating or crackling feeling when you bend or move the joint
  • swelling and inflammation around the affected joint, and the skin may also be red and hot to the touch
  • tenderness
Sometimes, you can get ‘referred’ pain from tendonitis, which means you feel the pain in another part of your body. For example, shoulder tendons can cause pain down the arm, away from the affected area. So consulting a doctor may be needed to determine the origin of the pain.7,8

Tendonitis risk factors

While anyone can develop tendonitis, certain risk factors can increase your overall likelihood.

Ageing

Tendonitis can affect you at any age but is more common in those who are middle-aged or older.9,10 

As we get older, wear and tear starts to take its toll with strain building up in your tendons. Over time, this can cause an inflammatory response in the body, leading to swelling, stiffness and pain.10-12 

Our tendons also lose flexibility and elasticity as we age, making them more prone to injury.11
 

Work environment

Maintaining a poor posture while at work can be a common cause of tendonitis.1,13,14 

People who work in jobs like gardening and manual labour, for example, put their bodies through a lot of repeated motions, awkward positions and various muscle vibrations, increasing their likelihood of developing tendonitis.13,15,16
 

Certain activities and sports

Playing sports like tennis and golf where the body repeats movements over and over can increase your risk of straining your tendons.3,4 Likewise, suddenly increasing how often or intensely you exercise can also strain your tendons.1 

Your risk of developing tendonitis can also increase if you use poor equipment, such as old shoes and heavy tennis rackets, or if you train on hard surfaces like concrete or gym floors.16,17
 

Certain medications and medical conditions

Sometimes, tendonitis can come about as a side effect of certain medications, such as some statins and antibiotics.18,19 It is thought your risk could also be increased by underlying conditions like diabetes, rheumatoid arthritis and gout.9
 

Which body parts can get tendonitis?

Tendonitis can affect any tendon in the body but most commonly develops in the wrist, hip, knee, elbow, shoulder or ankle.1,3
Here’s a quick rundown of some of the most common forms of tendonitis.

Shoulder tendonitis

Rotator cuff tendonitis, also known as swimmer’s shoulder, causes inflammation of one of the tendons in the top of the shoulder.20,21

When experiencing this, you might feel discomfort when you move in certain ways, such as lifting your arm above your head, reaching for something or putting your hand behind your back.21
 

Elbow tendonitis

There are two types of elbow tendonitis – tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis). Tennis elbow affects the outer side of the elbow, while golfer’s elbow affects the inner side of the elbow.22,23 

Tennis elbow affects around 40% of adults and is most common in those aged 35 to 54. It can be caused by any kind of activity that involves repeated gripping or twisting of your forearm, like racquet sports, moving a computer mouse, painting or cutting up food, for example.24 

As its name suggests, a golfer’s elbow can be caused by the repeated swinging of a golf club. It can also be caused by throwing a ball over and over, or by repeated elbow movements like hammering in nails.25,26
 

Wrist tendonitis

Wrist tendonitis, or De Quervain’s syndrome, is tendonitis at the back of the wrist that causes swelling in the thumb tendons.27,28

It’s commonly brought on by everyday activities that involve repeated thumb movements like texting, gaming, using scissors and typing. The condition is also associated with pregnancy and can even come on for seemingly no reason at all.27,28
 

Knee tendonitis

Knee tendonitis (patellar tendonitis) is tendonitis at the front of the knee.29 Also known as jumper's knee, it’s most common in people who play sports that involve a lot of jumping like basketball and volleyball, or those who train on hard surfaces.29,30
 

Ankle tendonitis

Achilles tendonitis affects the heel and ankle and is particularly common in people who run, dance, do gymnastics, or play squash or tennis.31,32
 
Shoulder pain, injury and back of senior black man after hiking accident outdoors. Sports, training hike and elderly male with fibromyalgia, inflammation or arthritis, broken bones or painful muscles

How to treat tendonitis

If you encounter any of the forms of tendonitis listed above, there are plenty of things you can do to help your tendon heal and reduce your symptoms.
One of the best places to start is using the ‘RICE’ protocol, which stands for rest, ice, compression and elevation.1,10,33

Here’s what you need to do:1,10,33
  • rest – your body needs rest to heal. So try to avoid any activities that you think may have caused your tendonitis, as well as anything that could make the pain worse, such as reaching your arm up or kneeling. Wearing a soft brace can also help reduce your movement 
  • ice – to bring down swelling and reduce pain, apply an ice pack to the injured area for up to 20 minutes every few hours. We find that a bag of peas wrapped in a towel can also work well! 
  • compression – wearing wraps or elastic tube bandages can help compress the area and reduce swelling
  • elevation – if tendonitis is affecting your knee or ankle, keep your leg raised using a pillow to help bring down swelling 
 As well as using the RICE method, the following treatment options can also help:10,34
  • gentle movement – while rest is important, gentle regular movement can help stop your joint from stiffening up1-3,34
  • take painkillers – over-the-counter painkillers and anti-inflammatory medications such as paracetamol, aspirin and ibuprofen can help relieve your pain in the first few days1-3
  • see your doctor – most symptoms of tendonitis improve with self-care treatments in just a few days. However, if you’re not feeling any better after three or four days, or if your tendonitis is affecting your ability to perform normal activities, make an appointment with your GP for further advice1,3

How to prevent tendonitis

Living with tendonitis can be painful and frustrating, which is why it’s best to avoid it if you can. So, with this in mind, here are some of the best ways to try and do exactly that:1,2,4 
  • always warm up and stretch before exercising
  • take breaks during workouts to give your tendons a rest
  • protect your tendons with splints and straps when playing sports
  • wear supportive shoes or insoles for exercise
  • make sure your work desk and chair are set up to support good posture
  • stop what you’re doing if it’s causing you any pain

The final say

The main thing to do when it comes to tendonitis is to listen to your body. Feeling twinges when you exercise? A bit sore after sitting at your desk all day? Take things easy and treat your tendons with some tender love and care using our treatment tips above. 

And remember, prevention is always better than cure. So make sure you prep for exercise, take regular breaks and kit yourself out with the right shoes and equipment. 

With our help, you’ll have all the gear and knowledge you need to reduce your risk of tendonitis both now and in the future!

Disclaimer

The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies.
 

Sources

  1. NHS. Tendonitis. [Internet]. 2023 [cited 2024 April 22]. Available from: https://www.nhs.uk/conditions/tendonitis/. 
  2. Bass E. Tendinopathy: Why the Difference Between Tendinitis and Tendinosis Matters. International journal of therapeutic massage & bodywork [Internet]. 2012 Mar 26 [cited 2024 Jun 10];5(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312643/ 
  3. Protect Your Tendons. Protect Your Tendons [Internet]. NIH News in Health. 2017 [cited 2024 Jun 10]. Available from: https://newsinhealth.nih.gov/2014/06/protect-your-tendons
  4. NHS Choices. Repetitive strain injury (RSI) [Internet]. 2024 [cited 2024 Jun 10]. Available from: https://www.nhs.uk/conditions/repetitive-strain-injury-rsi/ 
  5. Overview: Tendon overuse injuries (tendinopathy) [Internet]. Nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG); 2022 [cited 2024 Jun 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555501/ 
  6. Kane SF, Olewinski LH, Tamminga KS. Management of Chronic Tendon Injuries. American Family Physician [Internet]. 2019 Aug [cited 2024 Jun 10];100(3):147–57. Available from: https://www.aafp.org/pubs/afp/issues/2019/0801/p147.html 
  7. Gibson W, Lars Arendt-Nielsen, Graven-Nielsen T. Referred pain and hyperalgesia in human tendon and muscle belly tissue. Pain [Internet]. 2006 Jan 1 [cited 2024 Jun 10];120(1-2):113–23. Available from: https://pubmed.ncbi.nlm.nih.gov/16359798/
  8. Tapscott DC, Varacallo M. Supraspinatus Tendonitis [Internet]. Nih.gov. StatPearls Publishing; 2023 [cited 2024 Jun 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551702/ 
  9. MSD Manual, Tendinitis and Tenosynovitis. [Internet]. 2024. [cited 2024 April 22]. Available from: https://www.msdmanuals.com/en-gb/professional/musculoskeletal-and-connective-tissue-disorders/bursa,-muscle,-and-tendon-disorders/tendinitis-and-tenosynovitis 
  10. Charnoff J, Subitchan Ponnarasu, Naqvi U. Tendinosis [Internet]. Nih.gov. StatPearls Publishing; 2022 [cited 2024 Jun 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448174/ 
  11. Kwan KYC, et al. Effect of aging on tendon biology, biomechanics and implications for treatment approaches. Int J Mol Sci [Internet]. 2023 Oct 14 [cited 2024 Apr 22];24(20):15183. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607611/
  12. McCarthy MM, Hannafin JA. The Mature Athlete. Sports health [Internet]. 2013 Apr 24 [cited 2024 Jun 10];6(1):41–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874221/ 
  13. Keir PJ, et al. Relationships and mechanisms between occupational risk factors and distal upper extremity disorders. Hum Factors [Internet]. 2021 Feb [cited 2024 Apr 22];63(1):5–31. Available from: http://journals.sagepub.com/doi/10.1177/0018720819860683 
  14. Pranab Kumar Nag. Musculoskeletal Disorders: Office Menace. Design science and innovation [Internet]. 2018 Dec 31 [cited 2024 Jun 10];105–26. Available from: https://link.springer.com/chapter/10.1007/978-981-13-2577-9_4 
  15. Malliaras P, O’Neill S. Potential risk factors leading to tendinopathy. Apunts Medicina de l’esport [Internet]. 2017 Apr 1 [cited 2024 Jun 10];52(194):71–7. Available from: https://www.sciencedirect.com/science/article/abs/pii/S1886658117300269
  16. NIAMS. NIAMS Health Information on Sports Injuries [Internet]. National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2017 [cited 2024 Jun 10]. Available from: https://www.niams.nih.gov/health-topics/sports-injuries 
  17. Hennig EM. Influence of Racket Properties on Injuries and Performance in Tennis. Exercise and sport sciences reviews [Internet]. 2007 Apr 1 [cited 2024 Jun 10];35(2):62–6. Available from: https://journals.lww.com/acsm-essr/fulltext/2007/04000/influence_of_racket_properties_on_injuries_and.5.aspx 
  18. Singh D, Pandit D, Doherty M. High dose inhaled Corticosteroids can cause Achilles Tendonitis. Respiratory medicine CME [Internet]. 2009 Jan 1 [cited 2024 Jun 10];2(1):15–7. Available from: https://www.sciencedirect.com/science/article/pii/S1755001708000912 
  19. Deren ME, Klinge SA, Mukand NH, Mukand JA. Tendinopathy and Tendon Rupture Associated with Statins. JBJS reviews [Internet]. 2016 May 17 [cited 2024 Jun 10];4(5). Available from: https://pubmed.ncbi.nlm.nih.gov/27490216/ 
  20. Davis DD, et al. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Apr 22]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470589/
  21. NHS. Shoulder impingement. [Internet]. 2020 [cited 2024 April 22]. Available from: https://www.nhs.uk/conditions/shoulder-impingement-syndrome/ 
  22. NHS Choices. Tennis elbow [Internet]. 2024 [cited 2024 Jun 10]. Available from: https://www.nhs.uk/conditions/tennis-elbow/ 
  23. Amin Kheiran, Pandey A, Pandey R. Common tendinopathies around the elbow; what does current evidence say? Journal of clinical orthopaedics and trauma [Internet]. 2021 Aug 1 [cited 2024 Jun 10];19:216–23. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8190485/
  24. NHS. Tennis Elbow / Lateral Elbow Pain. [Internet]. 2024 [cited 2024 April 22]. Available from: https://plr.cht.nhs.uk/download/1137/Tennis 
  25. Hospital for Special Surgery. Golfer's Elbow (Medial Epicondylitis). [Internet]. [cited 2024 April 22]. Available from: https://www.hss.edu/condition-list_golfers-elbow.asp 
  26. Kiel J, Kaiser K. Golfers Elbow [Internet]. Nih.gov. StatPearls Publishing; 2023 [cited 2024 Jun 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519000/ 
  27. NHS. De Quervain’s syndrome. [Internet]. [cited 2024 April 22]. Available from: https://www.newcastle-hospitals.nhs.uk/services/newcastle-occupational-health-service/physiotherapy/de-quervains-syndrome/ 
  28. Satteson E, Tannan SC. De Quervain Tenosynovitis [Internet]. Nih.gov. StatPearls Publishing; 2023 [cited 2024 Jun 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442005/ 
  29. Patellar Tendinopathy | NHS Lanarkshire [Internet]. Scot.nhs.uk. 2021 [cited 2024 Jun 10]. Available from: https://www.nhslanarkshire.scot.nhs.uk/services/physiotherapy-msk/patellar-tendinopathy/ 
  30. Santana JA, Mabrouk A, Sherman AL. Jumpers Knee [Internet]. Nih.gov. StatPearls Publishing; 2023 [cited 2024 Jun 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532969/ 
  31. Medina MA, Naqvi U. Achilles Tendinopathy [Internet]. Nih.gov. StatPearls Publishing; 2023 [cited 2024 Jun 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538149/ 
  32. Bupa UK. Achilles tendinopathy. [Internet] 2022 [cited 2024 April 22]. Available from: https://www.bupa.co.uk/health-information/muscles-bones-joints/achilles-tendinopathy 
  33. NHS. Sprains and strains. [Internet]. 2023 [cited 2024 April 22]. Available from: https://www.nhs.uk/conditions/sprains-and-strains/ 
  34. Kane SF, Olewinski LH, Tamminga KS. Management of Chronic Tendon Injuries. American Family Physician [Internet]. 2019 Aug [cited 2024 Jun 10];100(3):147–57. Available from: https://www.aafp.org/pubs/afp/issues/2019/0801/p147.html
 

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