it is a tendinopathy, that is a pathology of the tendons or of the attached structures.Identification of symptoms: although the diagnosis must be medical-orthopedic, early recognition of the onset of the problem could favor a positive and less complicated course; the symptoms of tendonitis include: Medical examination: it is divided into: Intervention on the triggering cause: varies according to the tendon involved. Some precautions are: If tendonitis is overt, the specialist will choose to apply conservative therapy or surgery: Ignore the symptoms, even if they are mild at first. Treating tendonitis early means significantly reducing frailty and damage over the long term. Try to heal yourself and do not seek medical attention, especially when the discomfort exceeds 8-12 weeks in duration. Do not deepen the diagnosis with specific analyzes. Leave the habits that led to the formation of tendonitis unchanged and focus solely on reducing pain. Continue to use and overload the painful area of the body. Not respecting the therapy (drugs, physiotherapy, medical treatments, etc.). Exclude surgery in case of calcifications.
low calorie. The basic principles are: Since tendonitis has an inflammatory basis, it could be useful to increase the supply of nutrients with a strong anti-inflammatory function: Antioxidants: The elimination of alcohol is decisive: these drinks favor overweight and compromise the pharmacological metabolism. , in which the triggering cause is a reduction in muscle tone, which causes the stretching of the tendons and the consequent rubbing on some bone vertices.
The drugs used are:Running or jumping on even and possibly intermediate terrain. Correctly carry out the specific gestures or sports exercises involved. Exclude the intake of anabolic drugs intended to increase muscle mass and strength (doping): they can create an imbalance between muscle strength and tendon resistance (especially of compromised tendons). Do not abuse local corticosteroid-based injections: these drugs, although very effective in fighting inflammation, favor the thinning of the tendons. Warm up properly before strenuous activities. Observe proper recovery and practice prescribed therapies following a tendon injury. Assume a correct posture. : is a therapeutic method that uses an electric capacitor to treat joint muscle injuries and tendinopathies. The mechanism of tecar therapy is based on the restoration of the electrical charge in the injured cells, to make them regenerate more quickly. Laser therapy: it is a treatment that uses electromagnetic rays directly on the affected area. The electron beam from the laser acts on the cell membrane and mitochondria, increasing metabolic activity, reducing pain and inflammation, creating vasodilation and increasing lymphatic drainage. Ultrasound: this system uses high frequency acoustic waves. It is very useful as an anti-inflammatory, stimulant of edematous reabsorption and to dissolve the adhesions that form during healing. It produces heat and increases the permeability of cell membranes. Shock waves (Extracorporeal Shock Wave Terapy): they crumble the small calcifications of calcific tendonitis. They are based on the localized release of acoustic impulses. Kinesio taping: it is not particularly effective on tendinitis, but it can be used in the milder forms. Take advantage of the traction of adhesive and elastic bandages, which sometimes contain small pharmacological concentrations of anti-inflammatories, applied to the skin. They should have a draining, slightly pain-relieving-anti-inflammatory and bracing function. Surgery: It is essential to repair the total rupture of the inflamed tendon and sometimes for the removal of calcifications. Physiotherapy: useful both before and after surgery. It optimizes the ability to move, avoiding overloading the tendons, starts muscle strengthening, prevents stiffness and improves functional recovery.
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It is an inflammatory-based disorder, triggered by an acute event (rarer) or by the chronic repetition of micro-stresses (more frequent).
Tendon damage seen in tendinitis can resolve spontaneously; however, the repair process that characterizes healing involves the formation of a less resistant, less elastic and almost always thinner tendon tissue.
The tendons most sensitive to the onset of tendonitis are those that reside near the joints: ankle, knee, elbow and shoulder (in particular: sural triceps tendon, quadriceps femoral tendon, forearm extensors, supraspinatus tendon).
Tendinitis presents with pain, swelling and redness (where visible); very often, moreover, they also cause: reduced elasticity, impaired mobility and stiffness, and increased risk of breakage.
The risk factors for tendonitis are environmental (work, hobbies, sports, etc.) and subjective (anatomical predispositions, muscle weakness, etc.).
The published material is intended to allow quick access to general advice, suggestions and remedies that doctors and textbooks usually dispense for the treatment of Tendinitis; such indications must in no way substitute the opinion of the attending physician or other health specialists in the sector who are treating the patient.
negative is caused by a "work activity.- Pain in specific movements.
- Pain on palpation.
- Swelling and redness (if noticeable).
- Joint stiffness.
- Impairment of functionality.
- Feeling of joint instability.
- Loss of strength and hypotrophy of the attached muscles.
- Thinning, stretching and brittleness of the tendons.
- History: functional evaluation, palpation, etc.
- Imaging tests:
- Ultrasound.
- Radiography (for diagnosis of exclusion).
- MRI (for diagnosis of exclusion).
- Correction of postural defects.
- Scaling of overloads.
- Correction of motor sport technique.
- Correction of other customary gestures.
- Choice of tools, aids or footwear suitable for subjective characteristics.
- Automation of certain work phases.
- ATTENTION! There are systemic pathologies or complications (for example lupus erythematosus, chronic renal failure, etc.) which favor the onset of tendon diseases.
- Conservative therapy:
- Rest of the involved area.
- Use of aids that decrease joint mobility and improve load management (braces, splints, canes or crutches, orthotics, etc.).
- Physiotherapy, preventive-rehabilitative gymnastics and stretching: essential for the recovery of trophism and muscle strength, and joint stability.
- Cryotherapy or cold therapy: works by decreasing inflammation and calming pain.
- Drugs: anti-inflammatory (non-steroidal or corticosteroid).
- Medical treatments: useful for reducing inflammation and stimulating tissue repair.
- Surgery: used when tendonitis undergoes complications, such as calcifications and rupture.
- Post-surgical rehabilitation: physiotherapy type and subsequently strengthening.
- Consume an adequate amount of calories, which is 70% of normal calories.
- Choose foods with a suitable metabolic impact (whole foods and foods without refined carbohydrates), preventing spikes in blood sugar and insulin:
- Achieve a good amount of dietary fiber: it helps to keep blood sugar under control, modulates fat absorption and has a positive effect on estrogen levels.
- Keep the fraction of simple carbohydrates no more than 10-16% of total calories: it is usually sufficient to eliminate all sweet foods, keeping 4-6 servings of fruit and vegetables, as well as 1-3 servings of milk and yogurt.
- Keep the fat fraction no more than 25-30% of total calories, preferring the "good" ones (raw vegetable oils and medium-fat blue fish) over the "bad" ones (saturated, hydrogenated, bi-fractionated, etc.).
- Omega 3: they are eicosapentaenoic acid (EPA), docosahexaenoic (DHA) and alpha linolenic (ALA). They have an anti-inflammatory role. The first two are biologically very active and are found mainly in: sardines, mackerel, bonito, sardinella, herring , alletterato, tuna belly, garfish, seaweed, krill etc. The third is less active but constitutes a precursor of EPA; it is mainly contained in the fat fraction of certain foods of vegetable origin or in the oils of: soy, linseed, seeds of kiwi, grape seeds etc.
- Vitamins: the antioxidant vitamins are carotenoids (provitamin A), vitamin C and vitamin E. Carotenoids are contained in vegetables and red or orange fruits (apricots, peppers, melons, peaches, carrots, squash, tomatoes, etc.); they are also present in crustaceans and milk. Vitamin C is typical of sour fruit and some vegetables (lemons, oranges, mandarins, grapefruits, kiwis, peppers, parsley, chicory, lettuce, tomatoes, cabbage, etc.). Vitamin E can be found in the lipid portion of many seeds and related oils (wheat germ, corn germ, sesame, kiwi, grape seeds, etc.).
- Minerals: zinc and selenium. The first is mainly contained in: liver, meat, milk and derivatives, some bivalve molluscs (especially oysters). The second is mainly contained in: meat, fish products, egg yolk, milk and derivatives, enriched foods (potatoes, etc.).
- Polyphenols: simple phenols, flavonoids, tannins. They are very rich: vegetables (onion, garlic, citrus fruits, cherries, etc.), fruit and relative seeds (pomegranate, grapes, berries, etc.), wine, oil seeds, coffee, tea, cocoa, legumes and whole grains, etc.
- It is advisable to eliminate junk foods and drinks, especially fast food and sweet or savory snacks.
- It is also necessary to reduce the frequency of consumption and the portions of: pasta, bread, pizza, potatoes, derivatives, fatty cheeses, fatty meats and fish, cured meats, sausages and sweets.
ATTENTION! It is not advisable to force excessively with stretching and strengthening exercises; in addition to generating pain, they could favor the rupture of a particularly thinned tendon.
- Cryotherapy: cold therapy is useful in reducing pain and inflammation. It should be performed 2 or 3 times a day. Ice should not be applied directly; on the contrary, it should be placed in a containment bag with water and applied by placing a woolen cloth to protect the skin.
- Braces, bandages and bandages: these are tools that are sometimes useful for the reduction of symptoms. They have the function of accompanying or limiting movements. In sports practice they cannot be very tight; on the contrary, during work it is possible to tighten them more vigorously, taking care not to compromise circulation.
The drugs used are:
- Analgesics: generally also with anti-inflammatory action, they are used orally, especially in the fight against pain:
- Paracetamol: for example Tachipirina ®, Efferalgan ® and Panadol ®.
- Non-steroidal anti-inflammatory drugs (NSAIDs):
- Systemic for oral use: they are more used than topical ones, as some affected structures may be difficult to reach through skin application (for example in the rotator cuff). They are also more powerful than ointments and gels. They may require the use of a gastroprotector. People with liver or kidney disorders are not always able to take them.
- Ibuprofen: e.g. Brufen ®, Moment ®, Spidifen ®, Nurofen ®, Arfen ®, Actigrip fever and pain ® and Vicks fever and pain ®).
- Ketoprofen: for example Arthrosilene ®, Orudis ®, Oki ®, Fastum gel ®, Flexen "Retard" ® and Ketodol ®.
- Diclofenac: for example Dicloreum ®, Deflamat ®, Voltaren Emulgel ® and Flector ®.
- Naproxen: for example Momendol ®, Synflex ® and Xenar ®.
- For topical use: they are mainly ointments or gels. They have the advantage of acting locally (useful for example on the Achilles tendon) without excessively straining the stomach and liver; however they are less effective. It must be specified that this is not the most suitable pharmacological category and persisting for a long time with their use could favor the worsening of the inflammation.
- Ibuprofen 10% lysine salt or 2.5% Ketoprofen (for example Dolorfast ®, Lasonil ®, Fastum gel ® etc.).
- Corticosteroids:
- Injectable by infiltration: they are used only if oral NSAIDs are not well tolerated for: allergy, gastric ulcer, diabetes, etc. If used for long periods they exert many side effects on connective tissues, especially tendons. They are the most drastic pharmacological solution, but also the most effective.
- Avoid slippery, too hard (asphalt) or too soft (sand) soils.
