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Tendinitis and Tennis Elbow
Tendons are strong, fibrous, band-like structures that connect the muscles to the bones. The contraction of a muscle brings about the direct pulling of a tendon (tightly fixed on the bone), producing a range of motion about a joint (i.e. knee, wrist, elbow, etc.). Tendons are tough but are subject to stress and overuse. Inflammation of the tendons secondary to overuse is known as tendinitis. This problem usually surfaces 1-2 days after the inciting event (activity or stress). Tendinitis occurs often in the wrist, knee, shoulder, and elbow joints [where it is known as tennis elbow]. A certain range of motion to the joint (either extension or flexion) will produce the pain of tendinitis.
COMMON SYMPTOMS AND FINDINGS OF TENDINITIS KNEE: Tendinitis occurs in the large tendon just below the knee cap. Straightening (extending) the knee, particularly against resistance, produces the pain. Local tenderness to this area is also common. Bouts of pain are most commonly occur after periods of exertion.
SHOULDER: At the upper portion of your biceps (follow your biceps muscle up to your shoulder with your finger), there will be tenderness to touch (press lightly). Any resisted action of the biceps muscle will be met with pain in the shoulder.
WRIST: Flexing your hand upwards at the wrist joint or dorsiflexion (the opposite of the "limp wrist" position) will produce the classic pain. There will also be tenderness across the tendons on the "top" side of your wrist joint (when you push on them).
ELBOW or TENNIS ELBOW: Any resisted "upwards" dorsiflexion of the wrist (see description above) will be met with pain along the OUTER aspect of your elbow joint. This area will also be quite tender to touching. This is typically seen in tennis players and weight lifters. Evaluation is by history and physical examination. The findings on physical examination usually provide the diagnosis. Treatment involves rest, occasionally splinting of the joint, wet warm compresses, and anti-inflammatory medications (ibuprofen). Medical follow-up is suggested. The "tennis elbow strap" (available at your local pharmacy) may help in the case of tennis elbow. A shoulder sling can be used in the cases of shoulder (biceps) tendinitis. Be sure to retain the ability to raise your arm high above your head on the affected side. "Frozen shoulder" can result in those who wear a sling, and do not perform range of motion exercises several times a day. Often elastic wrapping (Ace wrapping) the wrist will provide adequate support for wrist tendinitis (don't wrap too tight). The Orthopaedic Surgeon is the expert in the ongoing care of these common orthopaedic problems.
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