Sportsman’s tendinopathy (or sportsman’s tendonitis) is characterized by inflammation or irritation of a tendon caused by repetitive or excessive movements when practicing physical activity. It usually causes a pain near the affected tendon and may limit the ability to perform certain activities. Rest, proper care and rehabilitation are often necessary to promote healing. The dot with the Dr. Maxime Pivot, physical and rehabilitation physician.

What is sports tendinitis?

Sportsman’s tendinopathy, also known as athlete’s tendinitis, characterized by inflammation of a tendon. “Tendons are fibrous structures that connect muscles to bones and allow joint movement.explains Dr. Maxime Pivot, physical and rehabilitation physician. When the muscle, which is the engine of the movement, finds itself in a position of relative weakness, it will then increase stress on the tendonleading to tendinopathy“Athlete’s tendonitis usually occurs due to repetitive motion, overuse, trauma, or excessive strain exerted on the tendon during sporting activity. “Sports involving repetitive movements, heavy loads or sudden movements are often associated with this type of tendonitis“. Common symptoms of athlete’s tendonitis are local pain, tenderness, swelling, joint stiffness and, in some cases, decreased muscle strength. “The pain is usually felt near the affected tendon and may be made worse by physical activity.” The diagnosis is primarily clinical with the attending physician or a specialist (sports doctor, rheumatologist, orthopedic surgeon). “Depending on the severity, the doctor may request images (ultrasound or MRI) to see the extent of the lesion. Treatment for athlete’s tendonitis may include rest, application of ice, anti-inflammatory medications, strengthening and stretching exercises with a physio, as well as physiotherapy modalities such as electrotherapy or ultrasound.

What causes sports tendonitis?

The onset of sports tendonitis is generally caused by multiple factors, often combined.
► Overuse : “It is one of the main causes of tendinitis in athletes.“, recognizes the doctor. “Of the repetitive and excessive movements constantly strain the tendons, which can lead to wear and tear“. For example, runners who complete long distances, tennis players who repeat hitting moves, or baseball pitchers who throw frequently are at increased risk of tendonitis.
► Poor technique or morpho-static disorders : “Incorrect sports technique or morpho-static disorders (flat feet, hollow feet, etc.) can put excessive pressure on the tendons, causing irritation and inflammation“.
► Mechanical factors (technopathies) : Certain extracorporeal mechanical factors can increase the risk of tendonitis in athletes. “This may include unsuitable footwear, ill-fitting equipment, hard or uneven training surfaces, which can lead to excessive stress on the tendons”.
► Lack of warm-up : Inadequate warm-up before strenuous physical activity may increase the risk of tendonitis. “Muscles and tendons need adequate preparation to avoid excessive tension. On the other hand, static stretching after exercise is not recommended because they risk aggravating certain lesions. It is better to favor a decontracting massage“.
► The medications. Some drugs like corticosteroidsTHE statins (anticholesterolemic), certain antibiotics (fluoroquinolones) or acne treatments (retinoids) can promote tendonitis.
► age. “With age, the production of collagen, which helps maintain the structure and strength of the tendon, is less efficient. It can also promote the occurrence of tendonitis.“.

It is important to note that athlete’s tendonitis can occur in any tendon in the body, depending on the movements involved in the sporting activity practiced.

Is it painful?

“We distinguish different stages of severity tendinopathies, according to the Blazina classification, answers our doctor:

• Stage 1: pain after exercise and disappearing at rest;
• Stage 2: pain before or at the start of the effort;
• Stage 3: pain during effort requiring cessation of activity.

Pain can vary in intensity and location depending on the tendon affected and the severity of the tendonitis. “The pain is usually felt near the affected tendon, often near the associated joint. It can be described as a throbbing pain, pulling, burning sensation, or a dull, persistent pain“The pain can be aggravated by physical activity, after physical activity, even during periods of rest if the tendonitis is advanced.”In some cases, the pain may be present even at rest, especially when there is significant inflammation of the tendon.”

How long does sports tendonitis take to heal?

The healing time for athlete’s tendonitis varies depending on several factors, such as the severity of the tendinitis, the location of the affected tendon, individual responsiveness to treatment, and the steps taken to promote healing. “In general, in milder cases, where tendonitis is detected and treated early, a period of relative rest, associated with appropriate care (application of ice, taking anti-inflammatory drugs, strengthening exercises and stretching), healing time is 6 weeks“, emphasizes our interlocutor. However, in more serious cases of tendinitis, where the inflammation is significant (for example, if the tendinitis is located near the insertion of a bone, healing can take several months.

Who to consult in case of sports tendonitis?

In the event of tendonitis in athletes, it is recommended to consult a qualified healthcare professional. “The attending physician is often the first point of contact for health issues, assures Dr. Pivot. They can assess your symptoms, perform a physical exam, and refer you to the appropriate specialist if needed.“. A doctor who specializes in injuries and sports-related medical issues may be a good option. “They have specific expertise in the management of sports injuries, including tendonitis. They can diagnose the condition, order further tests, recommend appropriate treatments, and provide advice on rehabilitation and injury prevention.“. The orthopedic surgeon is a specialist in musculoskeletal disorders, including tendon injuries. “They can assess tendinitis, prescribe additional tests if necessary (such as ultrasound or MRI), recommend appropriate treatments. Finally, physiotherapist (physiotherapist) specializing in sports injuries plays a key role in the management of tendonitis in athletes. “They can design a rehabilitation program that includes specific strengthening and stretching exercises, manual therapy techniques, as well as physical modalities such as electrotherapy or ultrasound“.

The treatment of tendinitis in athletes aims to relieve pain, reduce inflammation, promote healing of the tendon and to prevent recurrences. “It is necessary to give yourself a rest period to allow the tendon to rest and recover”, advises our specialist. “This may involve a temporary reduction or cessation of sports activity straining the affected tendon”. It may be necessary to temporarily or permanently modify the activities that strain the affected tendon. “This may involve reduce intensity, frequency or duration of the activity, to modify the sports technique or to use appropriate protective equipment”.

► Applying ice to the affected area can help reduce inflammation and relieve pain. “Use an ice pack or an ice pack wrapped in a thin cloth. Apply for approximately 15-20 minutes, several times a day, making sure to allow rest periods between applications“.
► Of the nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to reduce inflammation and relieve pain. “However, they should only be used as recommended by a healthcare professional.“. Of the anti-inflammatories can also be applied locally.
► A physiotherapist can design a rehabilitation program specific to strengthen surrounding muscles, improve flexibility, correct athletic technique and promote tendon healing. “This may include strengthening, stretching, stabilization and proprioception exercises“.
► Finally, physiotherapeutic methods for analgesic purposes (electrotherapy, ultrasound), histological (shock wave therapy) or healing (deep massage) can be used to promote tendon healing and reduce pain.
► In cases of chronic tendonitis, other options may be considered, such as injection of platelet-rich plasma (PRP). “But it’s still relatively expensive.”

Can you play sports with sportsman’s tendonitis?

When a person suffers from sports tendonitis, it is generally recommended to temporarily reduce or avoid sporting activities that strain the affected tendon. The goal is to allow the tendon to rest, heal and recover.
However, this does not necessarily mean that you should stop all physical activity. “In many cases, it is possible to engage in moderate activity that do not aggravate tendon pain or inflammation“, offers the sports doctor. “In general, it is recommended to follow the recommendations of the health professional“.IIt is essential to listen to your body, not to rush the healing process and to respect the signals of pain or discomfort. “Recovery must be gradualwhile carefully monitoring the reactions of the tendon”.

Thanks to Dr. Maxime Pivot, Head of Assistant Clinic, Physical Medicine and Rehabilitation at Toulouse University Hospital.