Tendinitis is the inflammation of a tendon, a tough rope-like tissue that connects muscle to bone, usually occuring in individuals in middle or old age asa result of overuse over a long period of time. Tendinitis does occur in younger patients as a result of acute overuse. Tendons that commonly become inflamed include those of the hand and of the upper arm that effect the shoulder.Achilles tendon, at the heel of the foot, and the tendon that runs across the top of the foot also may develop tendinitis.

Sudden stretching or repeated overuse causes injury to the connection betweenthe tendon and its bone or muscle. The injury is largely mechanical, but when it appears, the body tries to heal it by initiating inflammation. Inflammation increases the blood supply, bringing nutrients to the damaged tissues along with immunogenic agents to combat infection. The result is swelling, tenderness, pain, heat, and redness if it is close to the skin.

Some tendon injuries are superficial and easy to identify. These include tennis elbow (extensor tendinitis) over the outside of the elbow, and Achilles' tendinitis just above the heel of the foot. There are several tendons in the shoulder that can be overused or stretched, and usually a shoulder will have more than one injury at a time. Tendonitis in the biceps may accompany a tearof the shoulder ligaments or an impingement of one bone or another. Careful pressure testing and movement of the parts is all that is necessary to identify the tendinitis.

Rest, ice, compression, and elevation (RICE) will treat the acute condition.The best way to apply ice is in a bag with water. The water applies the colddirectly to the skin. Chemical ice packs can get too cold and cause frostbite. Compression using an elastic wrap minimizes swelling and bleeding in an acute sprain. Splinting may help rest the limb. Pain and anti-inflammatory medications (aspirin, naproxen, ibuprofen) will help. Sometimes the inflammation lingers and requires additional treatment. Injections of cortisone-like medicine often relieve chronic tendonitis, but should be reserved for resistant cases since cortisone can occasionally cause problems of its own. If tendinitisis persistent and unresponsive to nonsurgical treatment, a surgery to removethe afflicted portion of tendon can be performed. Surgery is also conducted to remove calcium buildup that comes with persistent tendinitis.

Increasing intake of antioxidant-rich foods and lowering intake of animal fats may help reduce the inflammation. Acupuncture has also been used to combattendinitis. Hydrotherapy, such as a whirlpool bath, may also help relax the surrounding muscles. If given enough time, tendons will strengthen to meet thedemands placed on them. They grow slowly because of their poor blood supply,so adequate time is required for good conditioning.

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