What is Tendinitis?
Tendons, thick cords that connect your muscles to bones, are more important than you might realize. For people who have had tendinitis (also called tendonitis), inflammation of the tendons causes pain and swelling, sometimes severe, and can make it difficult to do the activities you love.
Tendinitis can affect people no matter the level of sport or play, and is frequently seen in sports including golf, tennis, jogging and CrossFit. For people with tendinitis, a frequently asked question is can they continue to play their sport or recreational activity?
The 4 Stage of Tendinitis
Tendinitis is classified into four stages. Depending on what stage you are in determines how much or how little you should practice your sport or physical activity.
Stage I of Tendinitis
There is pain only after participating in an activity. An example of this would be lateral elbow pain (tennis elbow) after a tennis match. At this stage there are no limitations in activities, but the person should make sure that they are stretching and icing the area after activity.
Stage II of Tendinitis
There is pain at the beginning and after an activity. Once the body part has warmed up, there is no pain, and it does not affect the way the person plays.
An example of this is a basketball player with patella tendinitis or jumper's knee. This person has knee pain while warming up. Once the tendon is warmed and stretched, they are able to play without pain. However, on completion of playing, the knee pain has returned.
At this point, participation is not limited, but it is important to identify why the tendinitis has started. This person should focus on stretching and strengthening the muscle imbalances to relieve strain on the affected tendon.
Stage III of Tendinitis
There is pain beginning, during and after participating in an activity, but play is not affected nor has the person altered how they are playing. An example would be a golfer with lingering medial elbow pain every time they swing the golf club.
At this stage, it's important to limit play to 50 percent participation. The golfer should play just nine holes of golf, not 18, and play fewer times during the week.
Stage IV of Tendinitis
This is the most painful stage with continuous pain. There is pain before, during and after activity. The pain alters how a person is playing, and they change the way they play to avoid pain. At this stage, there needs to be complete rest.
For more information on tendinitis treatment, check our media center for articles like Is heat or cold better for tendonitis?
Pamela Ziegenfus, PT, is a physical therapist at OrthoCarolina Huntersville Physical & Hand Therapy.
This article was originally published on December 15, 2017, and has been updated on January 13, 2022.