You may never think about your tendons until you experience joint pain or injury. There are over 4,000 tendons in your body, and they connect your muscles and bones together in order to move your body. Injuring a tendon can be very painful and can limit your movement. While many people may think tendon injuries are something mainly athletes should be concerned about, the truth is they can happen to anyone.

Tendon Pain and Injury

Tendons contain bundles of fiber, which a type of tissue called endotenon surrounds. This tissue enables bundles of tendon fibers to move against one another, supporting body movement. A tendon injury may seem to happen suddenly, but usually it is the result of many tiny tears to the tendon that have happened over time.

Tendon injuries are relatively common, especially in people who play sports. An estimated 30 – 50% of sporting injuries involve tendon problems.
Tendon injuries can vary in cause and severity:

Strain: A common sports injury is a strain, which is damage to a tendon or the muscle to which it connects. The injury can be very painful. Severe strains may take weeks or months to heal. Trauma from falling or suddenly twisting a tendon can cause a strain. People who are inactive may be more vulnerable to strains, especially if they suddenly become active or experience muscle weakness because of inactivity.

Tendinitis: Tendinitis happens when a tendon becomes inflamed and irritated. Tendinitis can develop following trauma, such as a strain, but it is most commonly an overuse injury. People with tendinitis may notice that the area is painful, swollen, and warm to the touch.

Tendinosis: Tendinosis is a type of tear that is similar to a strain, but it usually happens over many months or years because of overuse or incorrect athletic technique.

Subluxation: Subluxation happens when a tendon moves out of place. A person might hear a popping or snapping sound when it happens and then experience pain and weakness in the affected joint. Sometimes, the pain will come and go. Subluxation is more likely in people with certain genetic anatomical differences, but tendons can also snap out of place as a result of an injury.

Rupture: Tendon ruptures can also occur. These injuries may be due to a combination of immediate trauma and chronic trauma. Ruptures commonly affect the Achilles tendons, biceps, knees, and quadriceps.
Conservative Treatment or Surgery?

The first thing to do if you have inflammation or a traumatic injury-causing tendon pain is to see a sports medicine or orthopaedic physician as soon as possible. This is important as swelling can affect the diagnosis of the injury. Your doctor will initially order imaging tests such as an ultrasound, MRI, or x-ray to ensure that you haven’t broken a bone.

If the tendon isn’t completely torn, you may choose to start with conservative treatment, such as physical therapy. Rest followed by physical therapy can often help heal the tendon.

If there is a severe partial tear or if the tendon is completely torn, the doctor will likely recommend surgery. Additional problems with your joints or bleeding within the injury will also be considered with a surgery recommendation. Your doctor will ultimately review the pros and cons with you and describe all of your available treatment options.

What Can I Expect if I Need Surgery?

Tendon repair surgery can significantly improve not only your movement, but your overall quality of life. In most cases, your surgeon will access the damaged tendon with specialized tools through a few minimally invasive incisions. Most of these surgeries are common and do not require an overnight stay in the hospital, depending on the location and severity of the injury.

After surgery, you may be given medication to reduce pain and swelling. However, regular application of ice along with anti-inflammatory medicine is usually all that is needed for recovery. More invasive tendon repairs, such as rotator cuff tears, often need to stay immobilized for several weeks.

In more ordinary cases, you could regain some range of motion in up to a couple of weeks. Finally, your doctor will give you a list of exercises to help you regain movement. A referral to a physical therapist may also be made to ensure that you get back to your full mobility and range of motion.

Take Pain Seriously

The earlier you catch tendon pain, the quicker it is to heal. While minor aches and pains may be the body’s normal reaction to activity, but if the pain persists you need to talk with your doctor before returning to activity. Pain should not affect a healthy active lifestyle. No matter the injury, UPMC offers specialized care covering a broad range of orthopaedic services and our providers can develop an appropriate treatment plan individualized to your needs.

UPMC Physician: Back in Action After Tendon Repair
By Ronald Campbell, MD
UPMC Orthopaedics

Dr. Ronald Campbell is an orthopaedic surgeon specializing in sports medicine at UPMC in Northcentral Pa. He sees patients at SH Sports Medicine, 1201 Grampian Blvd., Williamsport; Medical Plaza at Mansfield, 416 South Main St., Mansfield; and UPMC Lock Haven, 24 Cree Dr., Lock Haven. To schedule an appointment with Dr. Campbell, call 570-321-2020. To learn more about UPMC Orthopaedics, visit UPMCSusquehanna.org/ortho.