Everything You Need To Know About Tendon Injury

What Is Tendon Injury?

A tendon injury, often referred to as tendinopathy, is a condition characterised by pain, swelling, and impaired function in the affected area. These injuries face a degeneration of the tendon due to chronic overuse. This happens when the tendons—tough fibres that connect our muscles to bones—are damaged or irritated. It commonly occurs around joints like the shoulder, elbow, wrist, hip, knee, and ankle.

In India, millions of people suffer from various forms of tendon injuries every year. These injuries can significantly impact the quality of life as they often involve critical areas such as the Achilles tendon or wrists, which are essential for mobility and day-to-day tasks. Data shows that such conditions are especially prevalent among older adults and those involved in high-impact activities or labor-intensive jobs.

What Causes Tendon Injury?

Tendon injuries result from a combination of factors that can either be gradual or sudden:

• Overuse and repetitive strain: In many cases, tendon injuries arise from repetitive motion or overuse. This continuous strain can cause microtears in the tendon fibres.
• Ageing: As we age, our tendons become less flexible and more prone to injury due to reduced blood flow and accumulated microscopic damage.
• Traumatic injuries: Sudden trauma from accidents or high-impact sports can cause severe tendon injuries, such as ruptures. One such example is the common Achilles tendon rupture.
• Improper technique or equipment: Using improper technique during physical activities or using unsuitable equipment can strain tendons and lead to injuries.
• Health conditions: Certain medical conditions, such as diabetes or arthritis, and some medications, like corticosteroids and fluoroquinolones, can weaken the tendons, making them more prone to injury.
• Eccentric loading: Activities that involve lengthening a muscle while it’s contracting (known as eccentric loading) can put excessive stress on tendons, thus increasing the risk of injury.

Types Of Tendon Injury

Tendon injuries typically fall into two main categories:

• Tendinitis: This is characterised by inflammation of the tendon, often caused by frequent, repetitive strain.
• Tendinosis: This occurs when the tendon itself degenerates or weakens, typically due to chronic overuse.

Common examples of tendon injuries are Achilles tendonitis (ankle), Patellar tendonitis (also known as Jumper’s Knee), Tennis elbow (also referred to as lateral epicondylitis), and Golfer’s elbow (medial epicondylitis).

Symptoms Of Tendon Injury

The primary symptoms associated with a tendon injury include:

• Pain and discomfort, particularly when using the affected tendon
• Stiffness in and loss of strength from the affected area
• Swelling, redness, and warmth if there is inflammation
• Crepitus, a sensation akin to crunching or creaking, when moving the injured tendon
• In severe cases, such as a ruptured tendon, you experience difficulty moving that affected joint.

Diagnosis And Evaluation

The diagnosis of a tendon injury is based upon several factors:

• Medical history and symptoms
• A physical examination that assesses pain, tenderness, range of motion, and strength
• An evaluation of how you use certain tools or sports equipment that could be related to your injury.
• Advanced methods like ultrasound or MRI may also be employed to understand more about your injury if it is severe.

How Can Tendon Injury Be Treated?

Treatment for tendon injuries, which include tendinitis and tendinosis, involves initial self-care measures, medical interventions, and possibly surgical options depending on the severity of the injury.

Initial treatment typically includes

• RICE Method: Rest, Ice, Compression, Elevation—each plays a significant part in reducing pain and swelling.
• Over-the-counter medications: NSAIDs like ibuprofen or naproxen are also typically suggested to alleviate pain and inflammation.

In situations where symptoms persist, several non-surgical treatments may be considered:

• Physical Therapy: Special exercises targeted at strengthening the muscles around the tendon and improving flexibility.
• Bracing or Splinting: These devices can immobilise the affected area while decreasing strain on the tendon.
• Corticosteroid Injections: These injections provide temporary relief from pain and inflammation.
• Platelet-Rich Plasma (PRP) Therapy: This therapy uses a concentration of platelets derived from your blood, which is then injected into the injured location to promote healing.
• Shock Wave Therapy: This non-invasive treatment uses waves of sound to stimulate healing in chronic tendon injuries.

If conservative treatments do not yield results, surgical intervention may be a necessity, especially for complete ruptures or severe tears. This could involve:

• Tendon Repair Surgery: The tendon is reattached to its original position or repaired using grafts from other tissues.
• Tendon Transfer: If a tendon is severely damaged, surgeons may transfer a healthy tendon from another part of your body to restore function.

Post-surgery, rehabilitation becomes crucial. Individuals typically wear a cast or boot for protection and carry out physical therapy to regain strength and mobility. Recovery time varies widely based on the severity of the injury as well as the complexity of the surgery, ranging anywhere from several weeks to months.

When Is A Tendon Injury Considered Serious?

A tendon injury can be considered serious under certain conditions that result in notable functional impairment or structural damage. Here are the primary indicators of a serious tendon injury:

• Loss of function: If there is an inability to move the affected joint or limb, it can suggest a severe tendon injury such as a tear or rupture.
• Visible deformity: Any visible abnormality in the affected area may indicate a total rupture of the tendon.
• Severe pain and swelling: Intense pain that fails to subside even with rest and over-the-counter medications, accompanied by rapid swelling, could be a sign of a serious injury.
• Audible snap or pop: A snap or pop sound at the time of the injury often indicates torn tendons or tendon rupture.
• Inability to bear weight: If you are unable to bear weight on the affected leg, particularly in cases of Achilles tendon injuries, it could potentially be severe.
• Rapid bruising: Immediate bruising after an injury also suggests a serious tendon injury.

Prevention of Tendon Injury

Preventing these injuries is possible through proactive strategies:

• Proper warm-up: Engaging in warm-up exercises before starting any physical activities helps prepare tendons for increased stress and reduces the risk of injuries such as ligament injuries and Achilles tendonitis.
• Gradual increase in activity level: Avoid sudden intensity or duration hikes in physical activities. Gradual strength building allows tendons to adapt, reducing the chances of injuries such as ruptures or tears.
• Strength training: Regular strength training for muscles around key joints can provide better support for tendons and reduce strain during activities.
• Use proper techniques: Following correct techniques during sports or daily activities minimises undue stress on tendons.
• Adequate rest: Allowing sufficient recovery time between workouts or repetitive movements can prevent overuse injuries.
• Wear appropriate footwear and equipment: Using well-fitting shoes and the right sports equipment can help control strain on tendons during physical activity.
• Stay hydrated and maintain overall health: Good hydration and overall fitness contribute to tendon health, reducing the risk of injuries.

Myths & Facts About Tendon Injury

Understanding tendon injuries is often clouded by myths. Here are some common misconceptions:

Myth: Only athletes get tendon injuries.
Fact: Anyone can develop a tendon injury due to activities or certain medical conditions.

Myth: Complete rest is the best treatment for tendonitis.
Fact: Gentle movement and specific exercises promoting tendon loading are more effective than inactivity.

Myth: Steroid injections provide a quick fix for tendonitis treatment.
Fact: Steroid injections can provide temporary relief but may weaken the tendon over time.

Myth: Pain always indicates damage in tendon tear treatment.
Fact: The level of pain doesn’t necessarily correlate with the extent of tendon damage.

When To Consult A Doctor For Tendon Injury?

You should seek immediate medical attention if you:

• Experience severe pain that does not improve with over-the-counter painkillers or home remedies.
• Cannot move the affected joint or limb or notice a distinct change in its shape.
• Hear a ‘pop’ or ‘snap’ at the time of injury.
• Rapid swelling or immediate bruising occurs after an injury.

Questions To Ask Your Doctor About Tendon Injury

Here are some common questions you may ask your doctor if you suspect a tendon injury:

• What is a tendon injury, and how can I identify it?
• What are the causes behind my tendon injury?
• How is a tendon injury diagnosed?
• What are the available tendonitis treatment or Achilles tendon rupture treatment options?
• Will I need surgery for my tendon injury?
• What measures can I take to prevent future tendon injuries?
• How can I manage the pain associated with my tendon injury?
• How long will it take to recover from a tendon injury?

How prevalent are tendon injuries in India?

What is the Achilles tendon and how can it get injured?

Why is the Achilles tendon so prone to injury?

What is a ligament injury, and how are they treated?

Can a ligament injury occur concurrently with a tendon injury?

Is it safe to continue exercising with a tendon injury?

Can a tendon tear heal by itself?

Are tendon tears and ruptures the same?

Are there any risks associated with ignoring a tendon injury?

Is it possible to prevent tendon injuries?

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