eMedicine Specialties > Emergency Medicine > Rheumatology

Tendonitis: Follow-up

Author: Mark Steele, MD, Associate Dean for Truman Medical Center Programs, Professor, Department of Emergency Medicine, University of Missouri-Kansas City
Coauthor(s): Jeffrey G Norvell, MD, Clinical Assistant Professor of Emergency Medicine, University of Kansas School of Medicine
Contributor Information and Disclosures

Updated: Mar 31, 2008

Follow-up

Further Inpatient Care

  • Patients with symptoms resistant to conservative therapy rarely require arthroscopic or open surgical treatment for tendon decompression and tenodesis.

Further Outpatient Care

  • Follow-up care with patient's primary care provider within 1-2 weeks is appropriate in most cases of tendinopathy.
  • Specialty follow-up care with orthopedics may be indicated for patients with symptoms resistant to conservative therapy.

Complications

  • Chronic disability
  • Tendon rupture
  • Adhesive capsulitis (ie, frozen shoulder)

Prognosis

  • In general, the prognosis is very good with rest and conservative therapy.

Patient Education

  • Quadriceps strengthening exercises for patellar tendinopathy
  • Change in training routine and/or equipment, if indicated
    • Runners with Achilles tendinopathy should wear proper footwear, run on softer surfaces, and avoid hills.
    • Patients with tennis elbow should maintain proper backhand technique, use a less tightly strung racket, and play on slower surfaces.
  • Range-of-motion exercises are recommended for patients with rotator cuff tendinopathy to avoid complication of adhesive capsulitis.
  • For excellent patient education resources, visit eMedicine's Foot, Ankle, Knee, and Hip Center and Hand, Wrist, Elbow, and Shoulder Center. Also, see eMedicine's patient education articles Tendinitis and Tennis Elbow.

Miscellaneous

Medicolegal Pitfalls

  • Achilles tendon corticosteroid injection, steroid injection directly into a tendon, or repetitive peritendinous corticosteroid injections may result in tendon rupture.
  • Prolonged shoulder immobilization for rotator cuff tendinopathy can result in adhesive capsulitis.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous editor, Charles V Pollack Jr, MD, to the development and writing of this article.



More on Tendonitis

Overview: Tendonitis
Differential Diagnoses & Workup: Tendonitis
Treatment & Medication: Tendonitis
Follow-up: Tendonitis
References
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References

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  2. Warden SJ, Metcalf BR, Kiss ZS, Cook JL, Purdam CR, Bennell KL, et al. Low-intensity pulsed ultrasound for chronic patellar tendinopathy: a randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford). Apr 2008;47(4):467-71. [Medline].

  3. Adler RS, Finzel KC. The complementary roles of MR imaging and ultrasound of tendons. Radiol Clin North Am. Jul 2005;43(4):771-807, ix. [Medline].

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  14. Sorosky B, Press J, Plastaras C, Rittenberg J. The practical management of Achilles tendinopathy. Clin J Sport Med. Jan 2004;14(1):40-4. [Medline].

  15. Tytherleigh-Strong G, Hirahara A, Miniaci A. Rotator cuff disease. Curr Opin Rheumatol. Mar 2001;13(2):135-45. [Medline].

  16. van Tulder M, Malmivaara A, Koes B. Repetitive strain injury. Lancet. May 26 2007;369(9575):1815-22. [Medline].

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Further Reading

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Keywords

tendonitis, pain at tendinous insertions, lateral epicondylitis, tennis elbow, medial epicondylitis, calcific tendinitis, rotator cuff tendonitis, patellar tendonitis, popliteus tendonitis, iliotibial band syndrome, shinsplints, Achilles tendonitis, supraspinatus tendonitis, bicipital tendonitis, Yergason test, Speed test, Renne test, tendonopathy, tendinopathy, tendinitis

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Contributor Information and Disclosures

Author

Mark Steele, MD, Associate Dean for Truman Medical Center Programs, Professor, Department of Emergency Medicine, University of Missouri-Kansas City
Mark Steele, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Jeffrey G Norvell, MD, Clinical Assistant Professor of Emergency Medicine, University of Kansas School of Medicine
Jeffrey G Norvell, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Richard S Krause, MD, Clinical Assistant Professor, Residency Program Director, Department of Emergency Medicine, State University of New York at Buffalo School of Medicine
Richard S Krause, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Gino A Farina, MD, Program Director, Associate Professor of Clinical Emergency Medicine, Department of Emergency Medicine, Long Island Jewish Medical Center, Albert Einstein College of Medicine
Gino A Farina, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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