Every time you move your body, there are tendons hard at work under your skin. Tendons, like ligaments, are made of fibrous connective tissue. They come in a variety of sizes and shapes depending on where they’re located and what they do, but there are just two types:

• Flexor tendons get their name from the flexing action they make by tightening and pulling on the bone such as when you make bend the knee back
• Extensor tendons extend to move the body outward or upward like when you extend your knee

You’ll find these workhorses all over the body, from your head to your toes. For example:

• Shoulder and arm tendons rotate and flex the limb and move it up and down
• Hip joints hold together with tendons, which help the leg move forward and backward
• Wiggle your fingers and you’ll use tendons to create that action
• Tendons help move your eyelids and jaw, too

Tendons allow movement but also act as shock absorbers and as tough little “bungee cords” that help stabilize our joints. They play a critical part in physical mobility.

You can injure a tendon in several, painful and uncomfortable ways.

Tendonitis can be a more chronic condition that occurs when the tendon becomes irritated and becomes troublesome.  Most commonly it is due to overuse of a particular tendon.  This is seen in people with repetitive motion jobs or with sports that require similar athletic movements.  Long distance runners or people that have drastically increased their recent activities are also common situations that lead to tendonitis.

Tendinosis may be another term your doctor uses when describing a tendon with a chronic injury. This means the tendon has had chronic injuries which have created degeneration of the tendon’s collagen.  This is often caused by:

• Overuse
• A contact sports injury such as football or soccer
• Rheumatoid arthritis can cause the tendon to tear or weaken

Tendinopathy is a catch-all phrase that means “tendon disease” and encompasses both tendon tears and inflammation.  You may hear that term from your doctor as well.

Over time your tendons can become damaged from repetitive motions. This can be from a job which may require you to do the same action repeatedly.  Sports or other daily activities can also cause long-term tendon damage. A sudden tendon injury usually occurs from traumatic injury. In all cases, you will experience a loss of strength, pain, stiffness, and a reduced range of motion in the affected body part. You may hear a crunching sound if you use the injured body part.

Professional athletes often experience these injuries. Basketball greats Kobe Bryant, Shaquille O’Neal, and Isiah Thomas, all experienced Achilles tendon injuries that required surgery and extensive rehabilitation. The American Academy of Orthopaedic Surgeons (AAOC) reports that “jersey finger” is a very common tendon injury on the athletic field. It happens when an athlete grabs the jersey of another player, the digit gets trapped, and when the other player moves the finger is pulled, ripping the underlying tendon off the bone.

If you’ve been injured, it will be difficult to diagnose a tendon injury, which manifests as swelling and pain when the muscle is moved. The area may feel hot to the touch. It’s a good idea to see your doctor to determine if there is a ligament or another injury – or if the problem is even with your tendon.

Tendon damage is called a sprain. Depending on the severity your doctor may require:

• Rest and immobilization to allow the tendon to heal on its own
• Icing throughout the day for 20-minute increments
• Wrapping the affected joint with a compression bandage
• Elevating the body part so that it’s higher than your heart to reduce swelling
• Medication, such as over-the-counter anti-inflammatories to help with pain
• Light stretching to keep the injury from stiffening

But if it was a traumatic injury that involves a broken bone, cut, or other damage, you may need surgery to reattach or repair the tendon. Your doctor will confirm this diagnosis with imaging tests such as an MRI, ultrasound, or X-ray to look at the bones around the tendon. Surgical repair of your tendon injury seeks to provide pain relief and bring back the normal range of motion you had before the injury occurred.

More than 200,000 people every year need tendon repair surgery. The tendon cannot regenerate if it is torn, so the typical treatment is surgical repair. The surgery and rehabilitation can return the joint to its normal function. Orthopedists most commonly surgically repair tendons in your ankles, elbows, fingers, knees, and shoulders.

Before the procedure, you will have an extensive diagnostic evaluation to be sure surgery is right for your particular diagnosis, health, and lifestyle.

During the procedure, you will be given anesthetic and the surgeon will make at least one small cut in the skin so they can see the injuries. Any damaged tissue will be removed and your orthopedist will carefully sew the tendon back together. Your doctor may also use a tendon graft to build the tissue back up. When the surgery is complete your doctor will stitch up the skin and a nurse will dress the wound.

Tendon surgery takes about 12-weeks to recover from, but the time varies by person and by the severity of the injury. Typically, these surgeries can be done in an outpatient setting with a less invasive arthroscopy procedure. If this procedure can be used you likely will not even have to spend an overnight visit in the hospital and recuperate comfortably at home.

Louisville Hip and Knee Institute provides patients with relief from pain and restores mobility with our state-of-the-art outpatient surgical center and talented, experienced team. Talk with us to determine the fastest and best ways to get you back to health.