Question
Hi Margot,

I keep banging up my tendons.  Three shoulder suregeries, tennis elbow and some knee pain.  At first the problems were considered related to sports and weight lifting.  I becoming more of a slug and now I'm hearing a kind of vibrating squeaking noise in my shoulder and elboe.  I'm tired of going to orthopedists and I feel like I am going to waste away into a fat and unhealthy slug.

Your advice is much needed.

Thanking you in advance,

Michael Bet

Answer
Hi Michael and thanks for writing,

Tendinosis is an accumulation over time of small-scale injuries that don't heal properly; it is a chronic injury of failed healing. Although you can't see the tendinosis injury on the outside of your body, researchers have seen what the injury looks like on the cellular scale by viewing slides of tendons under the microscope. Tendinosis can occur in many different tendons, with some of the most common areas being the hand, wrist, forearm, elbow, shoulder, knee, and heel.

Tendinosis can result from long hours of activities such as playing sports, using computers, playing musical instruments, or doing manual labor. It can result from activities performed as part of your profession or recreation. Some occupations that have increased risk for chronic tendon injuries include assembly line workers, mail sorters, computer programmers, writers, court recorders, data entry processors, sign language interpreters, cashiers, professional athletes, and musicians.

You can minimize your risk for tendinosis by using equipment that has good ergonomic design and is sized correctly for your body, by using good technique for your activity (whether it is sports or music or typing), by taking plenty of breaks, and by minimizing long overtime hours (easier said than done!). You can also listen to your body's pain signals. Warning signs of tendinosis include burning, stinging, aching, tenderness to the touch, and stiffness.

Usually tendinosis sneaks up on you. At first the pain only comes after a long or hard session of the activity that aggravates it. Later the pain comes at lower levels of the activity and it lasts longer. Finally, the pain becomes a part of your daily life and even normal activities can make it worse. Try to catch the injury as early as you can.

Once people get tendinosis, it usually becomes a long-term chronic problem with no easy solution. Many people have to change careers because they can't get their injuries to heal well enough to go back to their jobs, even if they make ergonomic improvements. They also have to make long-term changes to their daily lives outside of work to accommodate the limitations caused by the injuries. When tendinosis in an upper extremity is at its worst, people often have trouble performing even the simplest daily tasks such as opening doors, brushing teeth, shampooing hair, cutting and stirring food, tying shoes, turning pages of books and magazines, picking up children, and writing checks.

We need more research to find effective treatments for tendinosis; we don't understand why tendons often fail to heal even after the injurious activity is stopped, and we don't know how to reverse the damage. No current treatment has been proven to reverse the microinjuries associated with tendinosis. The injuries usually improve with time, rest, and physical therapy (and also with some nontraditional treatments), but no treatment has been shown to reverse the damage on the cellular scale. We could help many people if we could find a treatment that consistently reversed tendinosis injuries.

I hope this helps and I wish you all the best,

Margot