Orthopedics Physical Therapy What Is Tendonitis? By Laura Inverarity, DO Laura Inverarity, DO Laura Inverarity, PT, DO, is a current board-certified anesthesiologist and former physical therapist. Learn about our editorial process Updated on November 19, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Stuart Hershman, MD Medically reviewed by Stuart Hershman, MD LinkedIn Stuart Hershman, MD, is board-certified in orthopaedic surgery. He is the director of adult spinal deformity & complex spinal reconstruction at Massachusetts General Hospital and is on the faculty at Harvard Medical School. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Causes of Tendonitis Common Locations Symptoms and Diagnosis Treatment Frequently Asked Questions Tendonitis (also spelled tendinitis) is an acute condition where the tendons that connect muscle to bone become inflamed. This inflammation can cause pain, loss of mobility in the tendon, and decreased strength in the muscle to which the tendon is connected. Tendons are fibrous cords of collagen that serve as flexible anchors to connect muscles to bone, in and around the joints of the body. They come in many shapes and sizes, from small ones which enable the movements of fingers, to larger ones, like the Achilles tendon, which help us stand or walk. There are many reasons why a tendon can become inflamed and, when it does, it can often be painful. The pain can be felt at the insertion site where the tendon attaches to the bone. It can also be felt where the muscle and tendon connect. Tendon problems are commonly referred to as tendinopathy. This is an umbrella term that simply refers to any abnormal condition of the tendon. These conditions can cause pain, inflammation, and limited mobility. Verywell / Jessica Olah Causes of Tendonitis While there are hundreds of tendons throughout the body, only a small handful are affected by tendonitis. These tendons tend to have fewer blood vessels servicing them, and the lack of blood supply hinders their ability to heal after injury. The parts of the tendon most impacted by this effect are called the watershed zones where the blood supply is at its weakest. Tendonitis is most often caused by the overuse of a tendon in the course of work, athletics, or daily activities. It is most often associated with repetitive movements such as that caused by assembly line work or sports like golf or tennis where an action is repeated excessively. Direct injury—such as a blow to the tendon—can also cause tendonitis. Inflammatory disorders, such as rheumatoid arthritis and osteoarthritis, can also give rise to both the sudden (acute) and persistent (chronic) inflammations of tendons. Tendonitis is more commonly seen in people over 40 with the risk and severity of symptoms typically increasing with age. Common Locations of Tendonitis Tendonitis can happen almost anywhere on the body where tendons exist and is typically classified by its location. Because the condition is often associated with repetitive movements, we tend to see it in people who perform certain tasks by routine or who engage in specific sports activities. Some of the more common types include: Achilles tendonitis, involving the tendon between the calf muscle and heel Patellar tendonitis, sometimes referred to as jumper’s knees Elbow tendonitis, commonly known as tennis elbow or golfer's elbow Biceps tendonitis, typically involving the tendon between the biceps muscle on the arm and its insertion in the shoulder joint. Rotator cuff tendonitis, known as swimmer’s shoulder Wrist tendonitis, sometimes called bowler’s wrist Symptoms and Diagnosis Tendonitis is typically characterized by recent appearance of pain and inflammation and should not be confused with tendinosis in which structural signs of tendon degeneration exist. In many cases, the appearance of symptoms will be gradual, often associated with a period of excessive activity and without significant injury. The symptoms may appear gradually and worsen over time. The most common features of tendonitis include: Swelling of the tendonTenderness directly over the tendonPain with the movement of the affected areaA cracking or grating sensation when the joint is movedThe appearance of a lump or bulge on the tendon itselfStiffness due to swelling Diagnosis is typically made with based on history and physical examination. If the cause is not clear or there are co-occurring conditions, the doctor may order additional tests. X-rays and magnetic resonance imaging (MRI) can be helpful in assessing for additional causes of symptoms. Treatment The treatment of tendonitis involves three elements: Initial limitation of movement of the affected tendonReduction of inflammationRehabilitation of the injured tendon, joint, and muscle which includes regaining normal tendon mobility and tolerance to loading. To achieve this, the injured joint can be immobilized to relieve any pressure on the afflicted tendon. Ice or non-steroidal anti-inflammatory drugs, like ibuprofen, can be used in the initial days to reduce swelling and pain. The main objective of treatment is to minimize the movements that can further inflame the condition. Depending on where the tendonitis is, you may need to reduce or modify simple, everyday tasks like driving or typing until symptoms are fully settled. In people with recurrent or severe symptoms, corticosteroid injections may be used to provide short- to medium-term relief. Overuse of injections should be avoided as it can weaken the tendon over time and increase the risk of rupture. Treatment may be supported by physical therapy to manipulate and massage the affected area. Recovery tends to be faster, often with the recovery of the full range of motion. Maintaining fitness and minimizing sudden changes in activity levels can help lessen the risk of developing tendinitis. A Word From Verywell Tendonitis can be a painful condition that limits your ability to engage in your normal work or recreational activities. If you suspect you have tendonitis, check in with your physical therapist and get started on treatment right away. Frequently Asked Questions What are the symptoms of tendonitis? Symptoms of tendonitis often include tendon swelling, stiffness, tenderness above the tendon, pain caused by movement of the affected area, a feeling of cracking or grating when the joint moves, or a lump or bulge that appears on the tendon. What treatment is there for tendonitis? Tendonitis treatment can start with rest, ice, compression, and elevation (R.I.C.E.). However, this will depend on its severity. A healthcare provider may recommend specific over-the-counter or prescription pain medications or corticosteroid injections. An exercise plan or physical therapy may also be part of the treatment. Learn More: How Tendonitis is Treated Can tendonitis affect the arm? Yes, tendonitis can affect the arm. Elbow tendonitis, biceps tendonitis, and wrist tendonitis are conditions that affect different locations on the arm. Are there diseases that cause tendon pain? Yes, certain diseases like rheumatoid arthritis or diabetes can cause tendon pain. These are systemic diseases that can eventually lead to tendonitis. Was this page helpful? Thanks for your feedback! Get exercise tips to make your workouts less work and more fun. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 3 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Scott, A.; Bachman, L.; and Speed, C. Tendinopathy: Update on pathophysiology." Journal of Orthopaedic & Sports Physical Therapy. 2015; 45(11):833-841. doi:10.2519/jospt.2015.5884 Murtagh, B. and Ihm, J. Eccentric training for the treatment of tendinopathies. Current Sports Medicine Report. 2013; 12(3):175-181. doi:10.1249/JSR.0b013e3182933761 MedlinePlus. Tendinitis. Reviewed August 13, 2020.