Tendonitis is an inflammation of a tendon—the thick fibrous cords that attach muscle to bone. This condition typically occurs due to overuse, injury, or repetitive strain on a tendon. The affected tendon can become irritated, swollen, and painful, making movement difficult.
What is Tendonitis?
Causes and Risk Factors
Tendonitis is often caused by repetitive motion or overuse, particularly during activities that involve high impact or frequent movement. Athletes, manual laborers, and anyone who regularly participates in physical activities are at greater risk. Other risk factors include:
- Age: Tendons become less flexible and more prone to injury with age.
- Poor posture or biomechanics: Abnormal movement patterns or posture can strain tendons.
- Sudden increase in physical activity: Overdoing exercise without proper conditioning.
- Inadequate rest or recovery time: Lack of rest between repetitive motions can strain tendons.
Symptoms
- Pain at the site of the tendon, which worsens with movement or activity.
- Swelling or warmth around the affected area.
- Limited range of motion due to pain and stiffness.
- Tenderness when touching or applying pressure to the tendon.
- In severe cases, a noticeable lump or thickening of the tendon.
Diagnosis
To diagnose tendonitis, your doctor will perform a physical examination, checking for tenderness, swelling, and range of motion. In some cases, diagnostic imaging such as X-rays, ultrasound, or MRI may be used to rule out other conditions and confirm the extent of tendon damage.
Treatment
Tendonitis responds well to conservative treatment, and the need for more invasive procedures is rare.
- Rest and Ice: Reducing activity and applying ice helps decrease swelling and pain.
- Physical Therapy: Targeted exercises to improve strength and flexibility can aid recovery.
- Medications: Anti-inflammatory medications like NSAIDs help manage pain and inflammation.
- Bracing or Splints: These can help protect the tendon and reduce movement while healing.
- Corticosteroid Injections: In certain cases, a corticosteroid injection can provide relief for inflammation.
- Platelet-Rich Plasma (PRP) Injections: PRP involves using your own blood to concentrate platelets, which contain growth factors that aid in the healing of damaged tendons. This treatment is beneficial for chronic tendonitis, particularly when other conservative treatments have not been successful.
In cases where conservative treatments fail, surgical intervention may be required:
- Tendon Repair: In severe cases, damaged tendon fibers may need to be surgically reattached or repaired.
- Tendon Decompression: If the tendon is entrapped or compressed, surgery can relieve pressure on the tendon.
- Tenotomy or Tendon Transfer: For chronic cases, the tendon may need to be surgically altered or replaced to restore function.
Achilles Tendon Problems
The Achilles tendon, located at the back of the ankle, is prone to various issues such as:
- Achilles Tendonitis: Inflammation of the Achilles tendon due to overuse or injury, causing pain and swelling.
- Achilles Tendinosis: Degenerative changes to the tendon, often a result of long-term overuse, leading to pain and weakness.
- Achilles Tendon Rupture: A complete tear of the tendon, which usually requires surgical repair to restore function.
- Achilles Tendon Tear: Partial tears can be treated with conservative methods or surgery, depending on severity.
- Haglund’s Deformity / Bump pain: A bony growth at the back of the heel that can cause irritation and pain in the Achilles tendon.
Peroneal Tendonitis
Peroneal tendonitis is a condition that causes inflammation and irritation of the peroneal tendons, which run along the outer side of the ankle and foot. These tendons help stabilize the foot and ankle during movement, making them essential for walking, running, and sports activities. Peroneal tendonitis often develops due to overuse, repetitive stress, or sudden increases in activity levels. It can also be caused by improper footwear, high arches, or a history of ankle sprains.
Symptoms of Peroneal Tendonitis
- Pain and tenderness along the outer ankle and foot
- Swelling and warmth around the peronea tendons
- Increased pain with activity, especially during walking or running
- Weakness or instability in the ankle
- A popping or snapping sensation in severe cases
Peroneal Tendonitis Treatment
Most cases of peroneal tendonitis can be treated successfully with conservative measures, including:
- Rest and Activity Modification: Avoiding activities that worsen symptoms can help reduce inflammation and allow the tendons to heal.
- Ice Therapy: Applying ice to the affected area can help decrease swelling and pain.
- Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to relieve pain and inflammation.
- Physical Therapy: Stretching and strengthening exercises improve flexibility, reduce strain on the tendons, and promote proper foot mechanics.
- Bracing or Taping: An ankle brace or supportive taping can help stabilize the tendons and prevent excessive movement.
- Orthotics and Proper Footwear: Custom orthotics or supportive shoes can help correct foot mechanics and reduce stress on the peroneal tendons.
For persistent or severe cases, advanced peroneal tendonitis treatments may be necessary, including:
- Platelet-Rich Plasma (PRP) Injections: PRP therapy can promote healing by using the body’s natural growth factors to repair damaged tendon tissue.
- Immobilization: In some cases, wearing a walking boot may be recommended to allow the tendons to rest and recover.
- Surgery: If the tendons have significant degeneration or tearing, surgical repair may be required to restore function and relieve chronic pain.
With proper treatment, most patients recover fully and can return to normal activities without pain. If you are experiencing ongoing ankle pain or instability, early evaluation and treatment can help prevent further damage and ensure a faster recovery.
Expert Care for Tendonitis
As a board-certified foot and ankle surgeon, I specialize in treating tendonitis and Achilles tendon pathology, with a strong focus on conservative treatments, especially for athletes. I understand the importance of returning to peak performance, and my approach prioritizes non-surgical methods such as physical therapy, rest, ice, medications, custom orthotics, and platelet-rich plasma (PRP) injections. For those cases that require more advanced care, my expertise in minimally invasive procedures and tendon repair has helped many patients regain full function and reduce pain. My expertise in this area is demonstrated through my peer-reviewed publication on surgical techniques for achilles bump pain, and surgical techniques for painful peroneal tendon pathology (read more) in the Journal of Foot & Ankle Surgery and Foot and Ankle Specialist.
