Softball tendonitis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Like all other sports, softball can lead to tendonitis.

The tendonitis may occur in a variety of areas:

Hip: Tendons on the outside of the hip can be stressed because of the sudden starts and stops. Pain on the outside of the hip may result. Oftentimes bursitis will also be present. These are usually in the trochanteric area. Specific exercises, physical therapy, ice, anti-inflammatory medicines, and injections are useful. Corticosteroids should be avoided if possible. Platelet-rich plasma (PRP) is preferred.

Knee: Patellar tendonitis or jumper’s knee is a common problem because of the quick cuts softball players need to make in the field. The pain is felt at the front of the knee and must be differentiated from chondromalacia- softening of the cartilage. The treatment for patellar tendonitis involves rest, physical therapy, anti-inflammatory medicine, and sometimes bracing.

Wrist tendonitis occurs because of the significant torque involved with both batting and throwing. The tendonitis can occur in either the flexor (bending) or extensor tendons of the wrist. The treatment involves physical therapy, anti-inflammatory medicines, splinting, and sometimes corticosteroid injection.

Shoulder tendonitis usually occurs in the rotator cuff. The biceps tendon in the front of the shoulder may also be affected since any throwing sport can injure this area. Pitchers are most prone to develop this problem although field players can also come down with this as well. Physical therapy, stretching and strengthening exercises, anti-inflammatory medicines, and glucocorticoid injections may help. Again, glucocorticoid injections should be used judiciously. One injection is fine but if the tendonitis recurs, rest, physical therapy, and platelet-rich plasma (PRP) is preferred.

Ankle tendonitis. This is less common than the others but may occur in players who have biomechanical abnormalities that predispose them to the problem. An example might be a player with flat feet who pushes off and develops posterior tibial tendonitis along the inside part of the ankle and foot. The treatment is similar to that for other forms of tendonitis. In addition, orthotics may be required. Another problem is Achilles tendonitis in the back of the ankle. The danger here is that if this medical problem is ignored, the Achilles tendon may rupture.

Elbow tendonitis commonly affects either the outside of the elbow or inside of the elbow. These are known as tennis elbow and golfer’s elbow respectively. Again, pitchers are more prone to developing these problems. A combination of medication, physical therapy, bracing, and corticosteroid injection is often required.

A newer treatment for tendonitis may be very effective and prevent the need for surgery. Percutaneous needle tenotomy is a technique where a small gauge needle is introduced using local anesthetic and ultrasound guidance. The needle is used to poke several small holes in the fascia. This procedure is called "tenotomy." Tenotomy induces an acute inflammatory response. Then, platelet rich plasma, obtained from a sample of the patient's whole blood is injected into the area where tenotomy has been performed. Platelets are cells that contain multiple healing and growth factors. The result? Normal good quality fascial tissue is stimulated to grow with natural healing.

For more information about this procedure, visit our sister site:
Tendonitis provides reliable, accurate, and useful information on tendonitis treatment written by a board-certified rheumatologist. Learn more about how to get tendonitis relief using the most up-to-date methods.

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