Both words are spelled correctly but tendinitis tends to be the more preferred term used in medical literature. More importantly, what is upper extremity tendinitis? The suffix “itis” means inflammation and the term tendinitis should be reserved for tendon injuries that involve larger-scale acute injuries accompanied by inflammation.(1) Risk factors include repetition, awkward postures, direct pressure, high force and prolonged static positioning.(2)
Symptoms of Tendonitis/Tendinitis
Symptoms can appear suddenly or develop over a period of time. The most common and insidious symptom is pain. It can sharp or dull, aching or burning and radiate up or down the upper extremity. Occasionally you can hear popping or see a bump. Other symptoms include stiffness, swelling and weakness. Signs can be more specific for certain types of tendinitis, such as difficulty gripping a pot with the arm straight with tennis elbow, or turning a key in the ignition with thumb tendinitis.
If left untreated, the symptoms can develop into chronic tendinitis. It can affect daily living activities, such as work or sports, and difficulty sleeping at night. It can radiate away from the affected area as well. It then becomes a condition called tendonosis. The suffix “osis” implies chronic degeneration without inflammation. Inflammation may be involved in the initial stages, but it’s the inability of the tendon to heal that perpetuates pain and disability(1)
Treatment for Tendonitis/Tendinitis
Treatment is varied as each patient’s causative factors and their response to treatment is unique. The first goal is to symptom control. Therapy goals are to decrease pain, and instruct the patient in symptom control techniques including rest, ice, and proper body mechanics in use of the upper extremity. This includes ergonomic training, such as work station design and adaptive aids and techniques. Splinting is usually indicated to rest the tendon/muscle unit, and may be designed specifically for the patient’s lifestyle. The material may be rigid, then progress to semi-rigid, soft support, and incorporate flexible taping such as kinesiotaping. Modalities such as ultrasound and electrical stimulation are also utilized.
Graston Technique (GT)
A specialized treatment technique called the Graston Technique (GT) is frequently implemented into the treatment program. “Graston Technique® is an innovative, patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break down scar tissue and fascial restrictions. The technique utilizes specially designed stainless steel instruments to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation”. (2) Training is required in order to become a GT provider.
Progressive strengthening can be initiated as long as initial symptoms are beginning to subside, and/or if symptoms are not increasing with exercise. As strength is restored, endurance and conditioning is started, but progressed slowly and flare-ups must be monitored and controlled.
Suffering from Tendonitis/Tendinitis? Visit One of Our Clinics
Rancho Bernado Physical Therapy Clinic
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References:
• Erickson, Laurie. Research Into Tendinosis (Commonly Known As Tendinitis) And Other Chronic Tendon Injuries, Tendinosis.org, 1/2004.
• Kasch, Mary C. Therapist’s Evaluation and Treatment of Upper Extremity Cumulative Trauma
Disorders, ppgs. 1005-1017, Rehabilitation of the Hand, Fifth Edition, 2002.
(3) Grastontechnique.com