Tendinitis Flashcards
Definition of tendinitis
Inflammation of a tendon
What is a tendon
-Dense collagen fiber that connect muscle to bone
-Part of the musculotendinous unit
2 types of tendons
-Paratendon
-Sheath
A paratendon surrounds
-A tendon that moves in a straight line
-Cord like
Tendon sheath surrounds
-Tendons that run across a bony prominence- filled with synovial fluid (bursa)
-Sheet like (aponeuroses)
Blood supply to paratendon
Blood vessels coiled in aveolar tissue-> vascularized
Blood supply to tendon sheath
-Blood supply compromised when tendon is exposed to compression, friction, torsion-> avascular
-Limited blood supply from mm to bone
Strength of tendon sheath
Have great tensil strength
What happens when placing load on tendon sheath
It will straighten out, collagen fibers will deform->accounts for 4% of tendon lengthening
What happens if a tendon sheath lengthens past 4%
Tendon will return to normal length
What happens if a tendon sheath lengths past 8%
Collagen links begin to fail-> causing microtearing, partial tearing, even complete rupture
Cause of tendinitis
Chronic overload of tendon
Contributing factors of tendinitis
-Muscle imbalance
-Poor Biomechanics
-Lack of flexibility
-Chronic degenerative changes in tendon
-Poor blood supply to tendon
Tendinitis due to
Microtearing of tendon fasicles do to overloading of tendon-> result in inflammation
Grade 1 tendinitis
Pain after activity only
Grade 2 tendinitis
Px beginning + after activity
Grade 3 tendinitis
Pain throughout activity + after, pain may restrict activity
Grade 4 tendinitis
With daily activity + tends to get worse
What is paratendinitis
Inflammation of Paratendon or tendon sheath
What is tendenosis
-Degenerative changes occurring with chronic overuse tendon injuries (tennis elbow) No inflammation in tendon itself
Contributing factors of tendenosis
Aging/avascularity may be contributing factors
Medical treatment for tendinitis acute stage
-Rest
-Ice
-NSAIDS
-Stretching
-Strengthening
-Return gradually to activity
-In arms use support strap
-Surgery- necessary with total rupture especially in shoulder
Other tendon pathologies
-Shoulder tendons
-Rotator cuff pathologies
Impingement syndrom
-Inflammation, pain, edema within coracoacromial arch ( between acromioclavicular + glenohumeral joints)
-Pain in tendon when humerus is abducted against acromion
-Downward curving or hooked
Rotator cuff tears due to
-Overuse
-Impingement syndrome
-Aging
What muscle is usually affected in Rotator cuff tears
Usually supraspinatus affected
What is Calcific tendinitis
Late- occurring stage of Rotator cuff tendinitis
Cause of calcific tendonitis
Extreme pressure on Rotator in internal rotation at 90% abduction
What happens to collagen in calcific tendonitis
-As collagen disintegrates, calcific deposits accumulate in cells
-Deposits are eventually re-absorbed causing pain and swelling
Cause of trigger finger
-Overuse of flexor tendon of any finger, may develope nodular swelling, unable to move through tendon sheath + gets caught, finger stuck in flexion
Symptom picture tendinitis acute stage
-Gradual onset, tenderness local to tendon one/two days after activity- increase to pain during activity
-Inflammation, heat along tendon/sheath
-Crepitus can develop
-Decrease ROM
Symptom picture tendinitis chronic stage
-Pain during + after activity
-Chronic- inflammation, fibrosis, adhesions
-Crepitus may be present
-Decrease ROM + strength
-Flare ups->acute
-Rupture can occure with tendon degeneration
Common tendinitis locations
Supraspinatus tendon
Infraspinatus tendon
Subscapularis tendon
Biceps long head tendon
Common flexor tendon
Abductor pollicis longus tendon
Extensor pollicis brevis tendon
Patellar tendon
Popliteus tendon
Tibialis posterior tendon
Achilles tendon
Contraindications
No friction with Anti-Inflammatory
