Inflammation, Sprain, Rupture And Damage To Tendons, Pain

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Inflammation, sprain, pain, rupture, and damage to tendons

Tendons connect muscles to bones. They are in the form of bridges that divide the muscle into several sections. And also short, long, wide, narrow. There may be cord-like, round, ribbon-like and lamellar tendons. The digastric muscles have intermediate tendons. They pass along the lateral surface of the muscle body and penetrate into its thickness.

Like a muscle, tendons are composed of parallel bundles. Bundles of the first order, surrounded by layers of loose connective tissue and constitute a bundle of the second order. The group of beams of the second order forms a beam of the third order. Tendons are made of dense fibrous connective tissue, they have more fibrous elements than cellular ones.

Due to this, their distinctive properties are high strength and low elongation. The tendon part of the muscles grows from 15 to 25 years faster than the abdomen of the muscles. Until the age of 15, tendons are poorly developed, their growth has the same intensity with muscle growth. In the body of the elderly, changes occur in the tissues, the elasticity of the tendons is disrupted, which often leads to injury.

The longitudinal elasticity of the tendon tissue serves to protect the tendons from rupture during sudden movements and overstrain. Therefore, in order to prevent injuries of the tendons, it is necessary to activate, develop and strengthen them, regular sports and the implementation of certain, special exercises will return them elasticity and strength.

There is a great saying, which contains great wisdom: "He who trains the tendons in his youth, he will receive vigor in old age." If physical effort is needed to train muscles, then the tendons are trained using static tension. With physical exertion, the tendons and fasciae are enriched with oxygen and become elastic, acquire endurance and strength.

Tendons must be elastic, the loss of this property leads to displacement of internal organs, a change in natural shapes, the formation of knots and seals. The strength of the tendons was known to the hero Zass Alexander Ivanovich, who created his own training method.

The commander Grigory Ivanovich Kotovsky, sitting in captivity, practiced static exercises and was famous for his unprecedented strength and endurance.

To identify the pathology of the tendons, methods are used - palpation, thermography, ultrasonography, biopsy.

Arthroscopy is effective if the tendons inside the joint are affected. Anomalies in tendon development are the result of malformations of the musculoskeletal system, atypical course or unusual attachment.

Diseases leading to tendon inflammation

There are several types of inflammatory diseases of the tendons, accompanied by disruption of the musculoskeletal system.

1. Tendinitis is an inflammatory process that occurs quite often. The reasons for its occurrence are always the same, and therefore, it is quite simple to identify this pathology when diagnosing. Tendinitis occurs from prolonged chronic overstrain, in which degenerative changes and tendon tears develop. This type of inflammation reduces the strength of the tendon and increases the risk of rupture.

Tendinitis can also have an infectious course. Athletes mainly suffer from the dystrophic type, due to heavy physical exertion on muscles, ligaments and tendons. Various rheumatic diseases of the joints also contribute to the development of such inflammation.

2. Paratenonitis is aseptic inflammation of the peritendinous tissue. It occurs with repeated trauma in the joint area. In this case, in the connective tissue, between the fascia and the tendon, after punctate hemorrhages and the appearance of edema, deposits of fibrous tissue appear. Nodular seals lead to painful sensations, movements are limited, activity is lost.

The disease damages the Achilles tendon, the extensors of the forearm, and the lower third of the lower leg. Paratenonitis can have an acute and chronic course. Treatment for tendon inflammation is to immobilize the hand or foot. Traditional physiotherapy treatments are also effective.

Treatment of acute inflammation of the tendon (tendinitis) involves antibacterial and restorative methods. In the case of aseptic tendonitis, non-steroidal anti-inflammatory drugs are used.

Local treatment consists in fixing the diseased limb. After the acute manifestations of the disease pass, physiotherapy procedures can be prescribed. Warming up should be performed after the acute manifestations of the disease have passed.

This complex of procedures includes UHF, microwave therapy, ultrasound, ultraviolet rays. Special physiotherapy exercises are useful. Soft heat and magnetic fields, improving blood circulation, relieve inflammation, edema of tissues disappears, and damaged parts of tendons are restored.

Tendon sprains, what to do?

Stretching is the most common type of injury, usually occurring in the ankle and knee joints from a sudden movement that exceeds their amplitude. Tendons connect muscles to bones, and ligaments connect bones. These two definitions are often confused. Ligament sprain is actually always a microscopic rupture with a slight sprain, with moderate trauma, individual collagen fibers may rupture if the injury is severe, the entire ligament is torn.

Having a high capacity for regeneration, the ligaments are restored at any degree of injury. The strongest muscles in humans are found on the lower limbs. This also means that the tendons that attach the muscles to the bones in the legs must withstand enormous loads. But, unfortunately, there are unsuccessful movements, falls, provoking a stretching of the tendons on the leg.

Stretching of the Achilles tendon occurs when the muscles are insufficiently warmed up during sports activities, when wearing uncomfortable shoes, or when walking on uneven, rocky surfaces. Tendon sprains can be divided into three degrees of difficulty:

• The first degree is minor pain after injury, aggravated by physical exposure.
• Second degree - severe pain, swelling of the skin over the damaged tendon. Muscle weakness and increasing pain during exercise are found.
• The third degree - complete or partial rupture of the tendon, muscle contraction occurs. At the time of rupture, a cotton sensation, sharp, severe pain and swelling are possible.

Usually, the third degree of tendon damage is repaired by surgery. Many victims in the first and second degree do not pay much attention to treatment and in vain, there may be a weakening of muscle strength, the development of inflammation in the tendon and in the "case" - where there are several of them. Basically, this phenomenon is observed in the tendons of the muscles of the foot and is called tenosynovitis.

Chronic inflammation is complicated by an atrophic process that affects the thinning of tendon fibers; they can be easily torn apart with light exertion. When stretching the tendons on the leg, first aid consists in immobilization, fixation in an elevated position. Then it is necessary to apply ice for 20-30 minutes (repeat 4-5 times a day), after which each time apply a pressure bandage using an elastic bandage to limit the spread of puffiness.

Ice will stop bleeding from damaged vessels. Severe pain is relieved by drugs such as diclofenac, analgin, ketans. On the second day, after removal of inflammation and edema, if there is no development of hematoma, the next stage of treatment is used, namely thermal procedures. Heat normalizes blood flow and the damage heals. The use of anti-inflammatory ointments is effective, among which Finalgon, Efkamon, Voltaren became popular.

The tendon recovers faster at rest, thanks to the consumption of foods rich in animal and plant proteins. A week later, under the supervision of a specialist, with the help of a set of exercises, they gradually put a load on the diseased muscle. Mechanical damage occurs as a result of direct or indirect action of a traumatic agent.

Direct action - blow with a blunt object. An indirect action is a sharp muscle contraction. Distinguish between closed injuries, among which there are gaps and dislocations much less often. Closed injuries include spontaneous ruptures, usually in chronic trauma and degenerative changes in the structure of the tendons. Also, the reason for the rupture can be infectious-toxic and metabolic-toxic factors, for example, diabetes, arthritis, and infectious diseases.

There are partial or complete subcutaneous tears without damaging the skin. Dislocation of the tendons as a result of rupture of the ligaments, ends with hemorrhage, swelling and pain when moving the joint. The displacement can be so strong that defects are visible during visual inspection. Especially when it comes to the extensors of the fingers of the hand. Dislocation treatment - its reduction, immobilization with a plaster cast for 3-4 weeks.

Surgical intervention is indicated for chronic and habitual dislocations, with a permanently reminiscent pain syndrome, with an obvious change in functional activity. Tendon rupture usually announces itself with a resounding crackle, unbearable pain and impaired motor function of the torn muscle. Open injuries are observed in stab, cut, chopped wounds, in severe injuries. Damage levels:

• Detachment of the tendon from the insertion site.
• Rupture along the entire length of the tendons.
• Tendon rupture in the zone of its transition to the muscle. Such phenomena are most likely to occur in older people and in those whose profession is associated with muscle overstrain or in athletes.

Rupture and damage to the tendons of the hand

Open injuries (stab, cut, chopped wounds) are observed in severe injuries, for example, after the hand gets into working mechanisms in production. Basically, there is damage to the tendons of the muscles of the upper limb at the level of the hand and forearm, more often it is the flexors. Both individual tendon injuries and a combination with damage to nearby vessels and nerves are noted.

When the hand is between the moving parts of the unit, its fragmentation occurs, lacerated wounds are obtained, the muscles contract and the ends of the tendons diverge. As a result of puncture wounds in the limb, the tendons are completely cut. Surgical restoration is required here; the operation is rather complicated and lengthy, because it is necessary to suture all damaged tendons in order to normalize the function of the hand. The application of an extensor dynamic splint accelerates the healing process of the tendon wound.

Rupture and damage to the tendons of the fingers

If the tendons of the fingers are torn, it is possible to detect the absence of active flexion in the distal interphalangeal joints of the hand. This is evidence that the deep flexor is damaged. If the absence of active movements in the interphalangeal joints is determined, then the superficial and deep flexors of the fingers of the hand are damaged. But the function of the vermiform muscles, which provides active flexion in the metacarpophalangeal joints, may remain.

By examining the sensitivity of the fingers, nerve damage is detected. The X-ray method for bruised and crushed wounds will definitely show the degree of damage to bones and joints. Open injuries of the flexor tendons of the fingers of the hand are more common. If there is damage in the area of the distal interphalangeal joint, flexion of the nail phalanx by 60 ° is possible, but extension is not feasible.

With the defeat of the tendon-aponeurotic extension of the extensors of the fingers of the hand at the level of the proximal interphalangeal joint, even if the integrity of its central part is broken, it is possible that the extension of the nail phalanx is, sometimes the middle one can be in the flexion position. Quite a common occurrence when the nail and middle phalanges are in a bent position when all three parts are affected. The extensor of the finger can be damaged in the area of the main phalanx, then active extension in the joints between the phalanges takes place, but the activity of extension of the main phalanx is not observed.

Damage to the flexors and extensors of the fingers of the hand has to be treated surgically. The exception is fresh ruptures in the region of the distal interphalangeal joint, where fixation in the position of hyperextension of the nail phalanx and flexion of the middle phalanx at a right angle for 1 to 1.5 months effectively help.

As for open injuries, first aid consists in stopping the bleeding, after which it is advisable to cover the wound with a sterile bandage and apply a transport splint. The trauma center will clarify the diagnosis, treat the wound, make a tendon suture, which, by the way, is contraindicated for lacerated wounds, bone fractures and joint injuries. Modern surgeons recommend plastic surgery for chronic injuries of the flexor and extensor tendons of the fingers.

Rupture and damage to the tendons of the foot

Damage to the tendons of the foot:

• The first degree - slight pain, slight swelling of the ankle. You can step on the foot. Unpleasant sensations disappear after a few days of treatment with special ointments and compresses.
• Second degree - medium-sized joint swelling, sharp pain when moving the foot.
• Third degree - tendon rupture, severe persistent pain, significant joint swelling.

A rupture and injury to the Achilles or calcaneal tendon (triceps calf muscle), which is attached to the calcaneal tuberosity and is very thick, results from severe stress. Usually the gap in this zone is complete. The causes of damage include direct injury after a blow with a hard object and an indirect effect arising from a sharp contraction of the triceps muscle of the leg.

The risk group includes athletes, an injury can occur, for example, in runners with a sudden load on the tendon at the moment the foot is lifted from the surface at the start, in athletes with a sharp dorsiflexion of the foot during a fall from a height. Partial damage to the Achilles tendon occurs with direct trauma from a cutting object. The victim has acute pain, sensation of a blow to the tendon.

Hemorrhage and edema are observed on the posterior surface of the lower third of the leg. A dent can be seen in the gap area. The patient cannot stand on the pads of the fingers, plantar flexion of the foot is impossible. First aid consists in anesthesia with drugs and delivery to the trauma department.

Treatment for fresh tears (no more than two weeks) - closed percutaneous suture. A plaster cast is applied to the affected area for 4 weeks, the leg remains in one position all the time. After removing the thread from the seam, the leg is fixed for 4 weeks in a different position.

If the injury is old (more than 2 weeks), usually scar tissue has already formed at the ends of the tendons, it is removed, a skin incision is made over the tendon, the ends of the tendon are sutured with a special suture according to the method of Dr. Tkachenko. If there is a tissue defect, plastic surgery is performed, followed by the imposition of a plaster cast for a period of 6 weeks. Full recovery is guaranteed with specific exercises and physical therapy.

The Achilles tendon is the strongest, it stretches with muscle tension and allows you to stand on your toes or jump. For diagnostics, X-ray of the ankle joint in lateral projection, magnetic resonance imaging, ultrasound equipment are used. Damage can also be identified using traditional palpation.

Tendons ruptured and damaged in the legs

On the legs there is a rupture of the tendon of the quadriceps muscle of the thigh. The quadriceps femoris tendon attaches to the surface and lateral portions of the patella and tibial tuberosity. This is a very strong connection, but the muscle also has strength, so from its sharp contraction, the tendon ruptures in the transverse direction in the area just below the attachment to the patella. At the moment of rupture, a crackling sound is heard and a sharp pain is felt over the knee.

A depression is formed, hemorrhage occurs, the tissues swell. The quadriceps muscle loses its tone, its tension leads to a hemispherical protrusion. Attempts to extend the lower leg become unsuccessful. First aid - splint and delivery to the hospital. For the treatment of a tendon rupture of the quadriceps femoris muscle, anesthetic therapy and stitching of the ends of the tendon with sutures made of absorbent material are used. The plaster cast is applied for 6 weeks. Then, physiotherapy exercises and physiotherapy are shown.

Tendon pain

Pain in the tendons of the legs and arms is experienced by many people. Doctors state that they have to deal with such complaints every day in their practice.

Tendon pathogens such as tendonitis, tendinosis, and tenosynovitis are not uncommon. Tendinitis develops with improper posture, prolonged sitting in an uncomfortable position, in the absence of warming up the muscles during sports. Infectious diseases, arthritis of the joints and diseases of the musculoskeletal system, different lengths of the limbs increase the load on the muscles and tendons.

If there is pain in the tendons, then it is felt in the adjacent tissues. Soreness can come on suddenly or gradually build up. Intolerable pain is characterized by the presence of calcium deposits, impaired mobility and capsulitis of the shoulder. Sharp pain is observed with tendinosis, because it is associated with tendon rupture. Tendons also hurt with tenosynovitis. The cause of pain in the tendons may be exceeded force of the organ's capacity. With prolonged exertion, tissue dystrophy develops, metabolism is disturbed.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".