Tendonitis results from chronic repetitive strain, sudden force, or impact. It is an inflammation of the tendon and its attachment. The condition has a tendency to become chronic, resulting in pain and muscle weakness.

While muscles are pliable and elastic, tendons are tough and resist to stretch. The main characteristics of muscles however are strength and tone. Muscle tone depends on its resistance to stretch. Tone is mainly a function of the central nervous system. Other factors are one’s constitution, age, level of stress, etc. Repetitive muscle strain, or excessive force may result in increased muscle tension, due to altered neuromuscular irritability and dysfunction. This in turn will adversely affect the tendon, causing chronic strain, leading to painful inflammation of the tendon. The chronically strained tendon may develop fiber tear.

Tendons attach to the periosteum that envelops and adheres to bones. Strain weakens the tendon attachment causing periosteal inflammation and subperiosteal fluid bubble. The bubble can cause periosteal detachment leading to a vicious cycle. Further strain will increase the size of the bubble and aggravates the detachment. The inflamed and detached periosteum is extremely painful.



Bursitis may occur at the shoulders, elbows, hips or knees and elsewhere. A bursa is a fluid filled sack and may be positioned around joints, functioning as a cushion to protect soft tissues from friction, caused by tight tendons during muscle contraction. When muscles are relaxed, tendons are slack. Upon muscle contraction the tendons become taut and sharp like a cable. They can cut into underlying soft tissues. Strenuous exercises may irritate and inflame the bursa, causing a defense mechanism to deposit salt crystals such as calcium into the bursa. Salt crystals make the bursa fluid thicker, harder and more resistant to pressure. During exercise salt crystals are rubbing like sand against the surrounding soft tissue. The ensuing inflammation results in painful movements.

In both conditions treatment is conservative consisting of physical therapy. Ultrasound may dissolve the salt crystals. Rest and judicious exercises are utilized beneficially.

For more information or for an evaluation please call New York Midtown Orthopedics at 212-758-4688.

Remember: timely diagnosis and treatment may prevent chronic pain, surgery and permanent disability.