Overuse injuries are a common thing with athletes. Whether you’re practicing swings day after day in baseball or trying to hit your PR on a front squat, inflammation is a common side effect of the normal recovery process, but when it becomes chronic, it can affect the tendons and turn into what’s called tendonitis.
If tendonitis is something you’ve never heard of before, read on to find out everything you need to know about it so you can handle it naturally on the off chance it comes up.
What Is Tendonitis and What Causes It?
Tendonitis, also sometimes called bursitis (although they’re slightly different), refers to inflammation or irritation of a tendon—the thick, fibrous cord that attaches muscle to bone 1. It causes acute pain, swelling, and tenderness, making it difficult to move the joint.
The joints most often affected are those of the shoulder, elbow, wrist, hip, knee, and ankle. And like with arthritis, the pain of tendonitis is often worse with movement. But unlike arthritis, the pain may be felt in an area far from the joint.
The most common cause of tendonitis is repetitive use. When athletes are doing the same motion repeatedly, the tendon becomes irritated and inflamed. If that motion is performed incorrectly, it increases the risk of developing tendonitis.
For non-athletes, tendonitis can also result from:
- Medical conditions (rheumatoid arthritis, diabetes)
Bursitis, on the other hand, is slightly different and involves inflammation of the bursa—the small sac that acts as a cushion between structures (bones, muscles, tendons, skin).
Bursa act to protect the corners of bone from damage when muscles or tendons are pulling around the corners, and when inflamed, can be very painful even without movement.
Common Types Of Tendonitis
While basically any tendon in the body can become inflamed, with athletes, there tend to be some that are more common than others:
- Patellar (kneecap)
- Shoulder (rotator cuff)
- Posterior tibial
- Lateral Epicondylitis (elbow)
You’ll also sometimes hear tendonitis referred to as golfer’s elbow or tennis elbow, swimmer’s shoulder, pitcher’s shoulder, or jumper’s knee.
Treatment Options For Tendonitis
The most common treatment for tendonitis is the RICE method to reduce inflammation and improve blood circulation to enable healing.
However, other traditional treatment methods aimed at controlling inflammation are corticosteroid injections and nonsteroidal anti-inflammatory medications (NSAIDs), but these may not be the most effective options 2.
The best options for treating tendonitis revolve around relieving pain, reducing inflammation, and preserving mobility.
- RICE method. RICE is a common treatment for many injuries. With injuries to soft tissue caused by overuse or poor movement patterns, immediate treatment generally includes adequate rest, cold therapy (ice), a tight bandage (compression), and elevating the area to reduce swelling.
- Physio. Depending on the extent of the injury, you may opt for a physical therapist that can provide hot/cold treatments, ultrasound (sound wave), laser, or water therapy. Soft tissue or joint mobilization (manual therapy) is another option that can aid the healing process, although therapy often isn’t needed for tendonitis.
- Pain relievers. OTC medications are typically prescribed to help reduce the pain associated with inflammation. They may include analgesics like ibuprofen or NSAIDs.
Stretching and strengthening, corticosteroids, glycerol trinitrate patches, and growth factors have all been investigated as treatment options 2. However, natural supplements are healthier, safer, and generally more effective long term.
Best Supplements For Tendonitis
If you’re looking to avoid the prescription route for treating tendonitis, here are the best supplements to use:
The potent anti-inflammatory effects of omega-3s make them an excellent supplement for tendonitis and other inflammatory conditions.
Several studies have found that long-chain fatty acids influence inflammation through several mechanisms. Still, many are at least in part mediated by changes in the fatty acid composition of cell membranes.
Altering the composition of cell membranes can modify membrane fluidity, cell signaling and gene expression, and the pattern of lipid mediator production 3.
Many of the cells involved in the inflammatory response are rich in the omega-6 fatty acid arachidonic acid and the omega-3s eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), but oral administration of EPA and DHA can alter the membrane concentrations.
Eicosanoids produced from arachidonic acid degradation are thought to contribute to inflammation, while EPA and DHA give rise to resolvins, which are anti-inflammatory 3.
Therefore, changing the fatty acid composition of cells affects the production of compounds that mediate inflammation.
But unlike traditional fish oil supplements that can contribute to inflammation because of toxins, contaminants, and rancidity, Performance Lab Omega-3 supplies safe, clean, and sustainable DHA+EPA derived from algae in the optimal 2:1 DHA to EPA ratio.
It’s free of mercury, heavy metals, PCBs, and other toxic contaminants associated with fish oil supplements, all delivered in NutriGels®--the world’s first vegan, carrageenan-free softgels.
Like omega-3 fatty acids, curcumin is a great supplement for treating any inflammatory condition.
Curcumin, the active constituent of turmeric, has potent anti-inflammatory properties that help to soothe and support achy joints, reduce joint pain, and help mitigate the effects of inflammation.
Despite being part of the Zingiberaceae (ginger) family, turmeric contains different bioactive compounds responsible for its specific properties.
Turmeric and its derivatives possess potent anti-inflammatory activities, but unlike other anti-inflammatories that modulate COX-1 activity, turmeric modifies NF-κB signaling, pro-inflammatory cytokines, COX-2, and 5-LOX activity 4.
A rodent study looked at the effects of curcumin for tendon healing and found that 200 mg/kg orally for 28 days elicited better results for total tendon healing both histologically and biomechanically 5, suggesting that curcumin may be an effective treatment for healing tendon conditions.
Another study used human tenocytes to study the mechanism of curcumin’s action on inflammatory signaling 6.
At concentrations of 5-20μm, curcumin appeared to inhibit IL-1β-induced inflammation and apoptosis; it helped down-regulate gene products that mediate matrix degradation, prostanoid production (COX-2), apoptosis, and stimulated cell survival.
As well, curcumin also suppressed IL-1β-induced NF-κB activation. Research concluded that curcumin helps to counteract significant inflammatory pathways involved in the development of tendonitis.
Because the goal of any supplements used for tendonitis is to reduce inflammation, Boswellia is another effective option. Also known as Indian Frankincense, Boswellia serrata and its gum-resin extracts have been used for centuries to treat various chronic inflammatory conditions.
According to studies, the four boswellic acids are largely responsible for inhibiting pro-inflammatory enzymes; acetyl-11-keto-β-boswellic acid appears to be the most potent inhibitor of 5-lipoxygenase, an enzyme responsible for inducing inflammation 7 but also inhibits other factors such as cytokines (interleukines and TNF-α), complement system, leukocyte elastase, and oxygen radicals are involved.
BA also prevents the TNF α-induced expression of matrix metalloproteinases MMP-3, MMP-10, and MMP 8.
Taken together, by modulating levels of pro-inflammatory cytokines, Boswellia appears to be an effective treatment for tendinopathies.
Methylsulfonylmethane (MSM) is a naturally occurring organosulfur compound that’s used in the management of pain, inflammation, allergies, infections, and many other conditions.
Because of its enhanced ability to penetrate membranes and permeate throughout the body, MSM is one of the top supplements for treating conditions of the joints and has been shown to be highly effective for rapidly reducing pain, swelling, and improving the functional ability of joints 9.
Research suggests that MSM's potent anti-inflammatory effects result from its inhibitory effect on NF-κB, resulting in downregulation of interleukin (IL)-1, IL-6, and tumor necrosis factor-α (TNF-α) synthesis—all markers of inflammation.
Due to its ability to inhibit NF-κB transcriptional activity, it also reduces the expression of enzymes and cytokines involved in free-radical formation 10; high levels of circulating free-radicals is an underlying factor for the development of many inflammatory conditions.
Glucosamine and chondroitin are two of the most popular supplements when it comes to joint health. They are two building blocks of cartilage, the tissue that cushions joints, and supplementing with them may help to prevent breakdown associated with natural wear and tear or conditions affecting the joints.
Studies support the use of glucosamine-chondroitin sulfate in treating tendon injuries; it appears to enhance tendon-to-bone healing by increasing hyaline cartilage formation and decreasing the formation of capillary vessels 11.
Similarly, another study found that supplementation with glucosamine chondroitin sulfate improved results of Achilles tendon healing in rodents, which may be due to decreased inflammation and stimulation of collagen synthesis 12.
Should I Keep Training If I Have Tendonitis?
We know it can be tempting to push through an injury because we always think we’ll take it easy and be okay, but depending on the extent of the injury, training through it may make things worse.
And when you’re taking things that kill the pain, you don’t realize that it’s being aggravated.
But if you want to stimulate healing and return to training ASAP, Performance Lab Flex needs to be part of your treatment protocol.
Flex is one of the best and most effective joint supplements to support you in everything you do. Active lifestyles can be hard on joints, tendons, and ligaments and can leave you feeling achy and stiff.
Whether you’re healing from an injury or looking for general joint health support, Flex’s ultramodern design uses nutrients specifically curated and combined for active joint demands.
It soothes and protects with easy-on-the-stomach botanicals AprèsFlex® Boswellia Serrata and CurcuWIN® curcumin, and lubricates and nourishes joints with Mythocondro® chondroitin, NutriGenesis® strontium, OptiMSM®, and corn glucosamine—all supplied in 100% vegan-friendly prebiotic-infused capsules.
Whether you’re an athlete who trains multiple times per day or work in a profession where repetitive movements cause pain and stiffness, getting the right supplements is key to maintenance, prevention, and treatment.
While there are many options available when something like tendonitis flares up—manual therapy, NSAIDs, analgesics, and more—these supplements work two-fold to prevent and treat, providing a long-term solution for healthy soft tissues no matter your daily activities.
- G Riley. The pathogenesis of tendinopathy. A molecular perspective. Rheumatology. 2004 Feb;43(2):131-142.
- BM Andres, GA Murrell. Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat Res. 2008;466(7):1539-1554.
- PC Calder. Omega-3 fatty acids and inflammatory processes. Nutrients. 2010;2(3):355-374.
- JW Daily, M Yang, S Park. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 2016;19(8):717-729.
- A Güleç, Y Türk, BK Aydin, OF Erkoçak, S Safalı, C Ugurluoglu. Effect of curcumin on tendon healing: an experimental study in a rat model of Achilles tendon injury. Int Orthop. 2018;42(8):1905-1910.
- C Buhrmann, A Mobasheri, F Busch, et al. Curcumin modulates nuclear factor kappaB (NF-kappaB)-mediated inflammation in human tenocytes in vitro: role of the phosphatidylinositol 3-kinase/Akt pathway. J Biol Chem. 2011;286(32):28556-28566.
- MZ Siddiqui. Boswellia serrata, a potential anti-inflammatory agent: an overview. Indian J Pharm Sci. 2011;73(3):255-261.
- F Fusini, S Bisicchia, C Bottegoni, A Gigante, F Zanchini, A Busilacchi. Nutraceutical supplement in the management of tendinopathies: a systematic review. Muscles Ligaments Tendons J. 2016;6(1):48-57.
- PR Usha, MU Naidu. Randomised, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis. Clin Drug Investig. 2004;24(6):353-363.
- K Sengupta, KV Alluri, AR Satish, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee. Arthritis Res Ther. 2008;10(4):R85.
- A Taşkesen, B Ataoğlu, M Özer, I Demirkale, S Turanli. Glucosamine-chondroitin sulphate accelerates tendon-to-bone healing in rabbits. Eklem Hastalik Cerrahisi. 2015;26(2):77-83.
- H Ozer, A Taşkesen, O Kul, HY Selek, S Turanlı, K Köse. Glukozamin kondroitin sülfatın onarılmış tenotomize sıçan Aşil tendonları üzerine etkisi [Effect of glucosamine chondroitine sulphate on repaired tenotomized rat Achilles tendons]. Eklem Hastalik Cerrahisi. 2011;22(2):100-106.