What is tendonitis?
Tendonitis is inflammation of the tendon structure. This is further classified into tendonosis, tenosynovitis and enthesopathy. Tendons are composed of woven collagen, similar in structure to rope. Their function is to move things. Tendonitis simply described inflammation somewhere inside the tendon. Tendonosis is a swelling or thickening within the substance of the tendon. This usually occurs after long-term strain and stress of tendons. Tenosynovitis is much more severe and describes inflammation of the lining or sheath of the tendon. This results in significant swelling around the tendon. An analogy for a sheath is Jim Bowie pulled his knife out of its cover. The knife would represent the tendon and the cover represents the sheath. The tendon glides inside the sheath with the help of tendon fluid, which allows the tendon to glide. The tendon itself is attached at it’s far end to bone and it origin to muscle. Enthesopathy is pain and inflammation at the attachment of the tendon to bone. Most tendons have counterparts, which balance motion of a joint. For instance in the ankle there is a tendon on the inside and outside that provide balance. An imbalance will cause tendonitis of one or the other.
What causes tendonitis?
Most tendonitis is caused by overuse and/or imbalance. Specifically tenosynovitis is caused by excessive friction of a tendon on its sheath. This can be caused by excessive speed of tendon motion or the degree of stretch or pull of the tendon. When the tendon pulls repeatedly on the bone to a greater degree than the body can handle, one will develop enthesopathy (attachment tendonitis). When the tendon is strained beyond its strength the microscopic fibers will rupture. Fluid will fill the void caused by this rupture leading to tendonosis (tendon thickening).
How we treat tendonitis?
The best treatment is prevention. Prevention can consist of stretching prior to exercise, as a tight tendon is more likely to tear. Strengthening the muscles around the joints places less strain on the tendons. The two most common types of tendonitis are Tibialis Posterior Tendonitis and Peroneal Tendonitis. Tibialis Posterior is on the inside of the ankle and the Peroneal Tendons are on the outside of the ankle. These work together like reigns on a horse. When they pull equally there are no problem but when one pulls harder than the other, tendonitis more likely to develop. Treatment consists of bracing, orthotics, orthotics, cortisone injections, physical therapy and in extreme cases surgical.
If you are having pain of your foot or ankle call our office for an appointment sooner rather than later to avoid possible surgery.