A Complete Guide to Tendon Injury
Just about every movement we make each day uses a tendon, which is why a tendon injury is such a common occurrence. Tendons connect muscle to bone. They come in many shapes and sizes depending on their position and the muscle to which they are attached.
Tendons are made up of collagen fibers which run parallel to one another. They are incredibly strong, which is why they do not tear easily. In fact, they are around twice as strong as the muscle to which they are attached. Sometimes tendons are ruptured but this is usually in the connection where tendon and muscle meet.
Types of tendon injuries
One type of tendon injury is called an avulsion. This is when the tendon itself is pulled away from where it attached to the bone. This injury is nowhere near as frequent as two other conditions, tendinosis and tenosynovitis. These are caused by using the tendon over and over again. Repetitive usage, especially in sports results in a common tendon injury.
Tendinosis has now replaced the term tendonitis in most usages. That’s because current research has determined that there is usually not inflammation involved, only a breakdown of the collagen tissue. Putting continual stress on a tendon, which happens in many sports, can cause this type of condition. An overuse tendon injury is very hard to treat and takes a long time to heal. Unfortunately, it is apt to reoccur once it has been established.
A similar tendon injury is called tenosynovitis. Some tendons have what is called a synovial sheath surrounding them. One of these is the biceps brachii long head tendon. The sheath is meant to keep friction to a minimum but sometimes the surface between the tendon and the sheath itself becomes irritated and inflamed.
When there is too much friction from overloading the tendon, this kind of tendon problem develops. The tendon can no longer glide up and down within the sheath without causing pain. An actual grating is occurring. The symptoms are limited range of motion and pain. The only way to tell if you have tenosynovitis instead of tendinosis is to find out if this particular tendon has a sheath.
Avulsions are particularly painful
An avulsion is a much more acute tendon injury which results in enormous pain. There is tremendous force involved--so much so that the tendon is actually torn away from where it attached to the bone. These usually occur when you have a very large muscle which the tendon attaches to a much smaller space on the bone. The hamstring is one place an avulsion can occur. You might see this sort of tendon injury if you play or watch baseball or football.
Tendon problems frequently occur in such areas as the heel or the elbow. Two common injuries in these areas involving tendons are the Achilles tendon on the heel and tennis elbow. If you are a runner you apply a lot of force to your Achilles tendon every time your foot hits the ground. Likewise, a tennis player uses his or her elbow in every shot. An overuse in these areas causes a breakdown of tendon fiber. There can be an acute immediate tear or you can have the breakdown over many years. In the latter you may just wake up the next day hurting and stiff.
Diagnosis and treatment
If this happens to you, you need to see your doctor for diagnosis and treatment. In addition to an examination of the area, you could need an imaging test, such as an x-ray, MRI, or ultrasound. In severe cases, you might need more than rest, ice, elevation and pain relievers. You might require physical therapy to strengthen the tendon before you can return to normal usage.