Repetitive one-sided movements or persistent mechanical irritation may cause an inflammatory reaction in the tendon sheath, and a minor inflammatory reaction in the tendon itself. The condition frequently becomes chronic and can be difficult to treat.
The Achilles tendon peritenon is mostly affected, along with the sheath and the tendons of the long head of the biceps, the supraspinatus tendon, and the extensor tendons of the wrist and ankle.
Symptoms and diagnosis
- In the acute phase, pain and occasionally crepitus are felt in the affected tendon during and after exercise.
- In chronic conditions, initial pain will often disappear during warm-up.
- There may be diffuse, nonfocal swelling and tenderness.
- Function is impaired.
- Soft tissue X-rays show swelling and sometimes calcification of the affected tissues.
When peritendonitis develops the athlete or trainer should:
- cool the injured area during the acute phase;
- rest the affected part actively until the pain resolves;
- apply local heat and use a heat retainer;
- consult a doctor if the problem persists despite these measures.
The doctor has the following treatment options:
- an exercise program which should start as soon as healing permits. In the initial phase, isometric exercises, without load, should be carried out; thereafter, dynamic exercises can begin and should include eccentric exercises, combined with careful stretching. At no time should these exercises exceed the pain threshold;
- supportive strapping and taping;
- anti-inflammatory medication;
- high-voltage galvanic stimulation;
- ultrasound or shortwave therapy;
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