Tendinitis (Tendonitis) is an inflammation of a tendon (Tough band of fibrous connective tissue that connects muscle to bone or muscle to muscle). Most common injuries related to tendinitis occur around the shoulders, elbows, and knees. Also, tendonitis can occur in the hips, heels and wrists. Underlying inflammatory rheumatic diseases (Referring to more than 100 different diseases that have in common an inflammatory process), such as arthritis or gout, attributed to causing tendonitis.
Elbow Tendinitis affects the lateral epicondyle (Outside the bony portion of the elbow where the large tendons attach to the elbow from the muscles of the forearm.) and medial epicondyle (Tennis Elbow, golfer’s elbow or Climber’s elbow – Inflammation occurs in the tendon connecting the many forearms flexor muscles (responsible for finger flexion, grip and forearm pronation or turning the palm downward) inside of the elbow. Many repetitive activities such as throwing, chopping wood with an ax, running a chain saw, racquet sports, shoveling, hammering nails or using many types of hand tools stress the same forearm muscles causing symptoms to develop, includes pain that starts on the inside bump of the elbow (Referring to the medial epicondyle). Small tears can develop in the forearm tendon when exerting too much activity. When the tears are unable to heal because of constant strain or re-injury, scar tissue never has a chance to fully heal, causing the injured areas to weaken and can be painful (Otherwise known as tendonitis). Tendinitis is more common in adults, especially those over 40 years of age, but does not exclude all other ages. When tendons age, they tolerate less stress, and are less elastic, and are easier to tear.
During a physical examination by a physician, will try to extend or stretch the forearm muscles and tendons, which helps to evaluate for elbow tendinitis. Confirmation of elbow tendonitis: Examination of X-ray for any calcium deposits on the medial epicondyle, and MRI scans or ultrasound (Uses a magnetic waves to create pictures of the elbow in slices, and show amount of damage to the tendon)
Available are options to treat elbow tendinitis: Anti-inflammatory medication such as Ibuprofen, Motrin, and Aspirin or a physician may inject into the elbow cortisone, providing temporary relief for a period of weeks to several months. Doctors have recommended for their patients physical or occupational therapist, offers tips to rest the elbow and suggest various activities, avoiding straining the elbow. Besides applying ice, electrical stimulation to ease pain and improve healing and gradual exercise techniques, strengths the forearm muscles. Surgery may be necessary, when other options fail to provide necessary treatment and relief. Medial Epicondyle Release Surgery removes the extra scar tissue from a tendon a surgeon splits. During the procedure any bone spurs (Pointed bumps that can grow on the surface of the bones.) are removed and the surgeon may decide to suture the loose end of the tendons to the nearby fascia tissue (Covers the muscles and organs throughout the body). The patient will either be under a general anesthetic or regional anesthetic (blocks only certain nerves for several hours). After surgery, requires keeping the elbow bent at a 90-degree angle in a removable splint. Pain and swelling controlled by applying ice and electrical stimulation treatments. Also, a therapist may apply massage and other types of hands-on-treatments to ease muscle spasm and pain. Patients have commonly taken four to six months to get back to work and sport activities.
Published in the November 2006 issue of The American Journal of Sports Medicine by authors Allan Mishra, MD, Terri Pavelko, PAC, PT, of the Menlo Medical Clinic, Stanford University Medical Center, Menl Park California: Presented a study, that had shown a new biologic treatment for tennis elbow (Elbow Tendinitis). Blood is drawn from a patient’s unaffected arm and spun down in a physician’s office lab to separate the blood components. Afterwards, approximately a half-teaspoon of this material contains 500 percent enriched platelets (Liquid portion of the blood containing the component responsible to form clots in response to injury and contains powerful growth factors that initiate healing in the tendon.) than whole blood. These platelets are injected into the tendon of the affected elbow. The procedure takes less than one hour. After, a two – year evaluation of patients that had undergone this procedure, reported a ninety-three percent complete satisfaction, and returned to work or sporting activities. Seven percent of those participants reported being partially satisfied. Previous studies applying this procedure had shown success in maxillofacial surgery, wound healing, microfracture repair (Commonly used in patients with less knee damage, involves drilling small holes in the knee to induce bleeding, clotting and thus tissue re-growth.) and in the treatment of plantar fasciitis (Pain in the bottom of the foot, especially when getting out of bed in the morning and standing on it or after sitting for a while.). Further research of this procedure is necessary, before it can be made available or approved by the Food and Drug Administration. According to Dr. Mishra: “All we did was speed the process by taking blood from a different area, concentrating it, and putting it back into an area where there was relatively poor blood supply to help repair the damage.”
