Tendon Injuries Specialist

Description 

Tendon injuries can cover a large number of issues from tendonitis to tears.

The tendon is often injured at the place where it attaches to the bone, and has direct pain at this point.

Cause

A weakened tendon is more likely to injure. Several things can lead to tendon weakness.

• Falls - Direct impact to the tendon from a fall or other blow is a common cause of tears.
• Jumping, throwing or running - Tendons usually injure after prolonged, repeated use, such as running allot or playing basketball.
• Tendinitis - Inflammation of the tendon weakens the tendon and causes pain. This condition is most common in people who participate in activities that overuse the tendon.  Common names for this condition are jumper's knee, little league elbow, Tennis elbow, as well as injuries to the Achilles or Rotator Cuff.
• Previous Treatments - Including prior surgery or Corticosteroid injections have been linked to increased tendon weakness and increased likelihood of injury.
• Certain Chronic Disease or Medications - Can disrupt blood supply or weaken the tendon. Issues such as Lupus, Diabetes, infection or the use of a certain class of antibiotic can increase the chance of tendon injury

Anatomy

 

A tendon is connective tissue that connects a muscle to a bone. There are hundreds of muscle to tendon to bone connections throughout the body. Working together, the muscles and tendons help our joints move.

Symptoms

• The main symptom of tendonitis is pain and tenderness where the tendon meets the bone.
• The pain usually starts after exercise, and continued exercise will likely increase the discomfort. Jumping, running, and throwing are likely to make the pain worse.
• You may begin to notice weakness in the area, particularly during exercises that put pressure on that part of the body.
• The area may feel tender to the touch. The area around the joint can also feel tight or stiff, particularly in the morning.
• A tear of the tendon is a serious injury, and may separate the tendon from the bone. A person may hear a tearing or popping sound, and will feel significant pain. Movement of the joint may be difficult and a person may be unable to move that joint at all.

Physical Examination

During your first visit, be prepared to explain how you hurt yourself and how it feels since the injury.  The more you can explain to your provider, the more they can understand your symptoms and medical history.

At your visit, your provider will perform a physical exam and evaluate all the structures of the area.  You will receive an x ray to determine if there are any fractures present.  X ray can assist with evaluating the bone structures and assist with determining the cause of the tendon issues.

Many tendon injuries can be diagnosed with a thorough physical examination of the joint, but other tests, such as a Magnetic Resonance Imaging (MRI) scan may be ordered. The MRI creates better images of soft tissues like the tendons.  These images allow the physician to determine if this injury requires non-surgical or surgical treatment.

Treatment

Treatment for tendon injury is most often Non-Surgical first.  After exhaustive non-surgical treatment, surgery may be needed to correct the problem.

If the tendon has been torn off the attachment, the first step is to surgically attach the tendon to its proper place.

Non-Surgical Treatment

Initially, the standard treatment is the RICE protocol.  This stands for:

• Rest. Take a break from the activity that caused the injury. You may need to use crutches to avoid putting weight on your leg.
• Ice. Use cold packs for 20 - 30 minutes at a time, several times a day.
• Compression. To prevent additional swelling apply an elastic compression bandage.
• Elevation. Lift your leg up higher than your heart.

In addition to the RICE protocol, there are many types of non-surgical treatment options for Patellar tendon injuries and all have their advantages and disadvantages.  Your Orthopedic Specialist can review these options and assist you in determining which will be most effective in treating your injury:

• Non-steroidal anti-inflammatory medicines
• Physical Therapy
• Bracing
• Taping
• Orthotics
• PRP (Plasma Rich Protein) injections
• Stem Cell Therapy 

Surgical Treatment

If the symptoms persist after exhaustive non-surgical treatment, you may need surgical treatment to correct the tendon injury.  There are many possible procedures to correct this issue, the best option is dependent upon the cause to the tendon injury.  The Orthopedic Surgeon may clean the tendon area, or they may correct bone abnormalities.  All the options will be discussed if non-surgical treatment does not rectify the tendon injury.  

Rehabilitation

The first line of treatment is always rehabilitation.  A physical therapy program will guide you in regaining your joint strength and function.  This may occur in conjunction with bracing or taping.  Your rehabilitation specialist will assist in the decision-making process for the best options.