The tendons hold our joints together; they connect bone to bone across a joint whereas ligaments connect muscle to bone to bring about the movement of the joint.
There are 27 bones in the hand, 34 muscles and over 100 ligaments and tendons.
In the foot there are 28 bones with 33 joints and 112 ligaments and tendons from 13 long calf muscles and 21 smaller foot muscles.
When you consider our daily footfall and manual workload, it is no wonder that most of us will experience tendon issues in our often neglected extremities
Tendonitis
Tendonitis is most commonly caused by overuse or overloading and is particularly prevalent in sporting activities or when work requires manual repetitive movements such as sanding, painting or handling heavy equipment. Inflammation of the tendon is caused by microscopic damage to the fibres of the tendon. The area will be red, swollen and painful to touch. Movements requiring the use of the tendon will be weakened and painful.
Inflammation of the tendon is caused by microscopic damage to the fibres of the tendon. The area will be red, swollen and painful to touch. Movements requiring the use of the tendon will be weakened and painful.
Tenosynovitis
Tenosynovitis describes inflammation of the tendon and its synovial sheath which protects the tendon from being caught up in the mechanics of the joint or joints which it is crossing over.
There are a number of possible causes of tenosynovitis depending on where in the body it occurs. Tenosynovitis of the finger and toe tendons is most commonly caused by repetitive activity and overuse such as running with incorrect footwear and using hand tools.
Musicians can also be prone to suffer particularly pianists and guitarists.
Other causes can be as a result of a wound infection, insect bite, rheumatoid arthritis, psoriatic arthropathy and diabetes.
Symptoms include pain in the tendon where it crosses over the joint and there may be swelling and redness. The joints operated by the tendon will be stiff (especially in the morning) and there may be loss of strength.
Stenosing Tenosynovitis AKA Tenovaginitis
Tenosynovitis in the hand or foot and which is left untreated can develop into Stenosing Tenosynovitis also known as Tenovaginitis or Trigger Finger or Toe.
Overuse causes the tendon to become inflamed and swollen so that it “catches” on the tendon sheath where it crosses over a joint.
Ganglions or cysts may occur between the very small joints of the hand or foot limiting movement and causing pain when trying to achieve normal activity.
If left untreated this inflammation can develop into a small nodule in the tendon which causes the finger or toe to get stuck in a bent position and then suddenly straighten with a painful pop.
Treatment
Ice packs or ice dunking and anti-inflammatory medication (as approved by your doctor) should be used as soon as possible to reduce inflammation and swelling.
Any activity involving the use of the tendon should be avoided and the limb should be rested. Occasionally, a sling, splinting or crutches may be necessary.
In more severe injuries your doctor may inject a corticosteroid drug, hyaluronic or local anaesthetic into the affected tendon.
Physiotherapy will be required to assess the severity of the condition, advice on splinting and treatments such as ultra-sound, deep frictions, passive stretching, auto-assisted stretching of the tendon, and provide a rehabilitation program to regain strength and flexibility.
Tracey Evans
The Physiotherapy Centre
+34 609 353 805
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