Tendinitis, Paratendinitis and Tendinosis

Of all the overuse problems associated with physical activity, tendinitis is among the most common. In the past, all conditions have been termed tendinitis and treated accordingly. There now are several different pathological entities. These are: tendinitis, paratendinitis, tendinosis, partial and complete rupture.

Tendinitis is a catch term for inflammation of the tendon itself, and can often co-exist with paratendinitis.

The cause of tendinitis usually results from microscopic tears within the tendon and triggering an inflammatory response within the tendon. Common areas susceptible to tendinitis are; achilles, patella, adductor longus, supraspinatus, biceps, tibialis posterior and flexor hallucis longus tendons.

The first signs of tendinitis are usually noticed following exercise and especially first thing in the morning. During the warm-up phase of exercise the pain frequently disappears and only returns after the cool down period. Consequently, the sportsperson can train through the pain in the early stages and therefore interfering with the healing process.

The main characteristics of tendinitis are tenderness, crepitus and local swelling.

Tendinitis responds well to a combination of; ice, rest, frictions, massage and strengthening once the tendon becomes less painful. When strengthening, eccentric exercises have been very successful in helping preventing recurrence.

Paratendinitis

Paratendinitis describes inflammation of the outer layer of the tendon and usually occurs when the tendon rubs over a prominence. It is also seen in association with tendinosis and partial tears.

Paratendinitis can also be called tenosynovities or tenovaginitis.

In a clinical situation it may be difficult to differentiate between tendinitis and paratendinitis. This is not a problem though, as the treatments of both conditions are identical.

Tendinosis

This condition describes a tendon that has significant degenerative changes with no clinical or histological signs of inflammatory response.

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