Pediatric tendinopathy

What is pediatric tendinitis?

Tendinitis is a type of tendinopathy or overuse injury that affects young athletes. Tendinopathies occur when there’s inflammation or damage to tendons, usually from repetitive movements (overuse). Tendons are strong bands of tissue that connect muscles to bones. Tendons and muscles work together to move joints, helping athletes jump, run, throw, or swing a bat, golf club or racquet. Performing these activities over and over can irritate a tendon, causing pain and swelling. Our team of orthopedic and sports medicine specialists expertly treat this sports injury.

What are the different types of pediatric tendinopathy?

Tendinopathy refers to any condition that causes pain and swelling in one or more tendons. There are different types of tendinopathies.

Tendinitis

Tendinitis is inflammation in a tendon that causes pain and weakness in the injured area. It’s often an overuse injury that occurs from doing the same movement over and over. Tendinitis can also come on suddenly (an acute injury) when trying to lift or throw a heavy object.

Children and young athletes are more prone to these types of tendinitis:

• Achilles tendinitis

• Elbow tendinitis (also called tennis elbow, golfer’s elbow and pitcher’s elbow)

• Flexor hallucis longus tendinitis (dancer’s tendinitis)

• Hip flexor tendinitis (snapping hip)

• Patellar tendinitis (also called jumper’s knee and Osgood-Schlatter disease)

• Rotator cuff or shoulder tendinitis (also called pitcher’s shoulder or swimmer’s shoulder)

Tendinosis

Tendinosis occurs when the fibrous tissue in a tendon weakens and breaks down. This breakdown of tissue happens slowly over time, which is why tendinosis mostly affects adults and doesn’t always cause symptoms. Less commonly, repetitive movements or overuse cause tendinosis in young athletes.

Paratenonitis

This painful inflammatory condition affects the paratenon, the thin sheath that covers a tendon. The tendon and sheath rub repeatedly against a bone, causing pain, swelling and sometimes a grating or popping sensation. Paratenonitis most commonly affects the Achilles tendon, which connects the calf muscle in the lower leg to the heel bone. It’s also known as peritendinitis and tenosynovitis.

What are the signs and symptoms of pediatric tendinitis?

• Musculoskeletal pain or burning sensation in the injured area, especially during activity

• Muscle weakness

• Popping or grating sensation

• Red, swollen area that’s tender to touch

• Stiffness or difficulty moving the affected limb

How is pediatric tendinitis diagnosed?

Our pediatric orthopedic and sports medicine specialists have extensive experience diagnosing all types of tendon injuries in athletes.

To diagnose tendinitis or other conditions, our team:

• Performs a physical exam

• Evaluates symptoms

• Reviews images from an MRI or ultrasound to determine the extent of the tendon injury

What causes pediatric tendinitis and other tendinopathies?

Tendinitis and tendinopathies are overuse injuries. Wear and tear on a tendon, often from performing the same movement repeatedly, causes tendinopathies.

Other causes of tendinitis and tendon injuries in athletes include:

• Lack of flexibility or strength

• Muscle imbalances or weaknesses

• Muscle overload (excess weight on a tendon)

• Poor sports conditioning or high-intensity training (overtraining)

How is pediatric tendinitis treated?

Without proper treatment and recovery, tendinitis and other tendinopathies can weaken the tendon. The tendon may stretch more than it should, causing a strain or tear. Our team customizes a treatment plan to treat tendinopathy and prevent more severe injuries. This personalized plan accounts for your child’s unique injury and their chosen sport. Our goal is to speed healing and ensure a safe return to play as quickly as possible.

At the Andrews Institute, young athletes benefit from a full range of treatments and programs. We offer:

Nonsurgical treatments for tendinitis and tendinopathies

Tendinopathy treatments include:

• Limiting activities until symptoms improve

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

• Compression with a brace or sports tape

• Orthotics

• Ultrasound-guided corticosteroid injections or oral corticosteroids

• Plasma-rich platelet (PRP) injections

• Therapeutic ultrasound or extracorporeal shockwave therapy (ESWT)

Advanced orthopedic surgeries to repair torn tendons

In rare instances, tendinopathy can cause a tendon to tear or rupture. Our orthopedic surgeons use different techniques to repair torn tendons, depending on the severity of the injury and its location.

Our team specializes in tendon repair procedures, including:

• Tendon debridement to remove damaged tendon tissue and stitch together the remaining healthy tendon.

• Tendon transfer to remove and replace the damaged tendon tissue with a healthy tendon taken from a different part of the body.

Specialized rehabilitation programs

Our rehabilitation programs bring together the experts and services a young athlete needs to safely return to play. Our programs include:

• Sports rehabilitation to build strength, endurance and agility.

• Physical therapy to improve flexibility and mobility with stretching exercises.

• Bridge training via the Sports Performance powered by EXOS program to help athletes resume activities as they finish sports rehabilitation.

• Running Program to learn proper running techniques that lower the risk of reinjury.

• Dance Sports Medicine Program to ease the transition back to dance at the end of physical therapy.

• Sprains, strains and other soft tissue injuries (American Academy of Orthopaedic Surgeons)

• Tendinitis (American Orthopaedic Society for Sports Medicine)

• Tendinitis (National Library of Medicine)

• Overuse injuries in children (Pediatric Orthopaedic Society of North America)