Exploring the Causes and Treatments of Chronic Tendonitis

At Atlanta Bone and Joint Specialists, we understand how frustrating and painful chronic tendonitis can be. This condition, marked by long-lasting inflammation and irritation of a tendon, often disrupts daily life and interferes with physical activity. Whether it’s an aching shoulder, a nagging elbow, or persistent heel pain, chronic tendonitis can make even the simplest tasks difficult.
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In this blog, we’ll explore the common causes of chronic tendonitis, how it differs from acute injuries, and the treatment options available to help you find lasting relief.

What Is Chronic Tendonitis?

Tendonitis is the inflammation or irritation of a tendon—the thick, fibrous cords that connect muscles to bones. While acute tendonitis often resolves with rest and short-term care, chronic tendonitis is a persistent condition that may last for several months or even longer.
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This long-term inflammation often stems from repetitive stress, improper healing, or underlying biomechanical issues. Over time, the tendon can begin to degenerate, a condition known as tendinosis, making treatment more complex and recovery slower.

Common Causes of Chronic Tendonitis

Several factors contribute to the development and persistence of chronic tendonitis. These include:

1. Repetitive Motions

Occupational or athletic activities that involve repeated movements—like typing, throwing, lifting, or swinging—can place continuous stress on a tendon. Without proper rest and form, this can lead to chronic inflammation. Conditions such as tennis elbow, golfer’s elbow, swimmer’s shoulder, jumper’s knee, and Achilles tendonitis are often linked to repetitive motion. These injuries are common in those who perform the same movements frequently without sufficient recovery or conditioning.

2. Poor Biomechanics or Muscle Imbalance

When muscles are weak or imbalanced, tendons often take on extra strain. For example, a weak core or glutes can cause improper foot alignment during walking or running, placing added stress on the Achilles tendon. Over time, these faulty movement patterns lead to inflammation and overuse injuries. Addressing muscle imbalances is key to reducing tendon stress and preventing chronic tendonitis.

3. Aging and Degeneration

Tendons naturally lose elasticity with age, making them more prone to injury. This puts middle-aged and older adults at greater risk for chronic tendon problems, especially when staying active or returning to sports. Aging tendons also heal more slowly, which increases the chances that a minor injury could progress into a long-term condition without proper care.

4. Inadequate Recovery From Acute Injury

A tendon injury that isn’t fully healed can easily become chronic. Returning to activity too soon—without proper rest or rehab—can aggravate the tendon and delay healing. Ignoring early symptoms or skipping treatment often leads to persistent pain and reduced function. Proper recovery is essential to avoid long-term complications.

Symptoms of Chronic Tendonitis

Chronic tendonitis may not be as sharp or intense as an acute injury, but the symptoms are persistent and can worsen with activity:
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• Dull, aching pain near a joint
  
• Stiffness, especially in the morning or after rest
  
• Swelling or thickening of the tendon
  
• Tenderness when touched
  
• Reduced range of motion
  
• Weakness in the affected limb

These symptoms often fluctuate, improving with rest and flaring up with use.

Diagnosing Chronic Tendonitis

At Atlanta Bone and Joint Specialists, we begin with a detailed medical history and physical examination to assess symptoms, range of motion, and strength. In some cases, imaging studies such as ultrasound or MRI may be ordered to evaluate the extent of tendon damage or rule out other conditions like tears or bursitis.

Effective Treatments for Chronic Tendonitis

Treatment for chronic tendonitis focuses on reducing inflammation, promoting healing, and correcting contributing factors to prevent recurrence. While some cases resolve with conservative care, others may require advanced therapies or surgical intervention.

Conservative Therapies

• Rest and Activity Modification: Avoiding aggravating movements allows the tendon to heal. Our team will help identify specific activities to limit and suggest safer alternatives.
  
  
• Physical Therapy: Guided exercises to strengthen surrounding muscles, improve flexibility, and correct mechanics are crucial for long-term recovery. Stretching and eccentric loading exercises have shown significant benefits for chronic tendon healing.
  
  
• Ice and Anti-inflammatory Medication: Applying ice and using NSAIDs (as recommended) can help manage pain and inflammation in the short term.
  
  
• Bracing or Taping: Temporary use of braces or kinesiology tape can offload stress on the tendon during activity.

Advanced Non-Surgical Treatments

• Corticosteroid Injections: These may provide short-term relief for inflammation but are used cautiously, as repeated injections can weaken the tendon.
  
  
• Platelet-Rich Plasma (PRP): This regenerative therapy involves injecting your own platelets into the affected tendon to stimulate healing. PRP has shown promising results in treating stubborn cases of tendonitis.

Surgical Options

Surgery is considered when conservative treatments fail and there is evidence of significant tendon degeneration or tearing. Procedures may include tendon debridement (removal of damaged tissue), tendon repair, or decompression, depending on the location and severity of the condition.
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Our orthopedic surgeons work closely with patients to explore all nonsurgical options before considering surgery and to ensure the best outcome if surgical intervention becomes necessary.

Preventing Recurrence of Chronic Tendonitis

Preventing chronic tendonitis is possible with the right approach:
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• Warm up properly before physical activity
• Cross-train to avoid repetitive stress
• Maintain flexibility and muscle balance
• Use ergonomic tools and posture techniques at work
• Don’t ignore early signs of tendon pain—early treatment is key

Our physical therapists and physicians at Atlanta Bone and Joint Specialists can design prevention plans tailored to your lifestyle and risk factors.

Let Atlanta Bone and Joint Specialists Help You Find Relief

Chronic tendonitis doesn’t have to limit your mobility or disrupt your life. At Atlanta Bone and Joint Specialists, we offer expert diagnosis, personalized treatment plans, and access to advanced therapies that target the root causes of tendon pain.
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If you’re dealing with persistent discomfort or limited function due to tendonitis, don’t wait. Schedule a consultation with our team today and take the first step toward lasting relief and restored movement.