Tendon Injury

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KEY POINTS

• A tendon injury is stretching or tearing of a strong band of tissue that attaches bone to muscle.
• Change or stop doing the activities that cause pain until the injury heals.
• A tendon injury can be treated with exercise, ice, and sometimes with medicine or surgery.

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What is a tendon injury?

Tendons are bands of strong tissue that attach muscle to bone. Tendons can be injured suddenly or they may be slowly damaged over time. You can have tiny or partial tears in your tendon. If you have a complete tear of your tendon, it is called a rupture. Other tendon injuries may be called a strain, tendinosis, or tendonitis.

What is the cause?

The most common cause of a tendon injury is increasing the length of time or intensity of an activity or exercise program too quickly. Tendon injuries in the knee, foot, and calf are common in athletes who do sports that involve running and jumping. Tendon injuries in the knees can also occur from biking. Activities like swimming, swinging a golf club, or pitching a ball can cause tendon injuries in the shoulder. Wearing worn-out shoes or being out of shape are other possible causes.

Body structure problems like having bowlegs, one leg shorter than the other, or flat feet can also lead to tendon injuries. Tendon injuries may also occur from repeated motion, like when you use a keyboard or hammer.

What are the symptoms?

Symptoms may include:

• Pain or tenderness
• Decreased range of motion
• Weakness
• Swelling

How is it diagnosed?

Your healthcare provider will ask about your symptoms, activities, and medical history and examine you. Tests may include:

• X-rays
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the injured area

How is it treated?

Tendon injuries can be mild to severe. The pain from minor tendon injuries often goes away in a couple weeks with self-care, but if you ignore the problem, you may start having more severe symptoms. The occasional pain will change to constant aching, pain, and stiffness before, during, and after exercise. The tendon will also hurt when the area around it is touched.

See your healthcare provider if the problem does not go away in a couple of weeks. Your provider may give you exercises to do at home, prescribe physical therapy or medicine, or give you a splint to rest and protect the injured area. If you keep having pain, your provider may give you a shot of a steroid medicine.

Irritated tendons can tear if they are not treated. If this happens, you may need a boot, cast, or surgery.

How can I take care of myself?

If you are having pain:

• Stop the activity that is causing the problem until the pain goes away.
• Use ice on stiff or sore joints after exercise or work. Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the area every 3 to 4 hours for up to 20 minutes at a time.
• Do ice massage. To do this, first freeze water in a Styrofoam cup, then peel the top of the cup away to expose the ice. Hold the bottom of the cup and rub the ice over the painful area for 5 to 10 minutes. Do this several times a day while you have pain.
• Keep the injured body part up on pillows so that it is above the level of your heart when you sit or lie down.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
• Put moist heat on the sore area for 10 to 15 minutes before you do warm-up and stretching exercises. Moist heat may help relax your muscles. Moist heat includes heat patches or moist heating pads that you can buy at most drugstores, a warm wet washcloth, or a hot shower. To prevent burns to your skin, follow directions on the package and do not lie on any type of hot pad. Don’t use heat if you have swelling.

You can keep doing activities that do not stress or cause pain to the injured area. Make sure to stretch before doing any activities. Also, you may need to cross train. That is, instead of doing only 1 sport, try different activities to prevent overuse of any one part of your body.

How can I help prevent tendon injuries?

Warm-up exercises and stretching before activities can help prevent injuries. Stretching after your activity may also help. If you have pain after exercise, putting ice on the painful area may help prevent injury.

Follow safety rules and use any protective equipment recommended for your work or sport. For example, when you exercise, wear shoes that fit properly and are made for the activity.

Use proper form and posture during your activities, whether the activities are sports or job-related. For example, if you play tennis, be sure your tennis stroke is correct and that your tennis racket has the proper grip size.