Massage for Tendinitis

Tendinitis (also spelled tendonitis) is the painful inflammation of a tendon (fibrous tissue that connects muscle to bone) that often occurs as the result of a repetitive strain or a muscular overuse injury. Massage is a type of manual therapy that can help relieve the pain associated with tendinitis and improve overall function by manipulating the affected area to reduce excessive tension in the connective tissue and muscles, and promote healing.

How Can Massage Help Relieve Tendinitis?

Treatments for tendinitis are intended to heal the injured tendon. Restricted activity, rest, anti-inflammatory medications, elevation, compression, and splinting are the first lines of treatment for tendinitis. Massage for tendinitis may help relieve excessive tension and help prevent the buildup of scar tissue via hands-on manipulation of the affected area. Icing may be done before and after massage to provide optimal relief.

Massage should not be given during the acute stage of a tendinitis injury (which is typically the first 48 hours after injury) and should not be performed when tissues are swollen or visibly inflamed.

Studies have suggested that deep transverse friction massage (also called Cyriax massage) is the type of massage that is most beneficial for treating tendinitis. With this technique, the fingers use short, abrupt, sweeping back-and-forth motions to move the skin but do not slide over it. The goal of transverse massage is to move across a ligament or tendon to mobilize it as much as possible. Transverse massage, when performed before active exercise, can help reduce the pain associated with tendinitis and restore mobility. Transverse massage is generally thought to be safe and effective for treatment of tendinitis, though larger studies are needed to conclusively determine the exact benefits of transverse friction massage for tendinitis.

The Active Release Technique is a patented soft tissue management treatment that reduces adhesions and scar tissue that may form as the result of tendinitis. This muscle manipulation massage technique is used to treat problems that occur with tendons, as well as muscles, ligaments, fascia, and nerves. This specific massage technique combines precisely directed tension by the practitioner with very specific active movements by the patient to release the contacted tissue. Treatments take about eight to 15 minutes for each area being treated and two to ten visits may be needed before full functionality is restored.

What is Tendinitis?

Tendinitis is the pain and tenderness that occur just outside of a joint as the result of inflammation or irritation of a tendon. Tendinitis commonly affects the shoulder (rotator cuff tendinitis), elbow (tennis elbow or golfer's elbow), wrist and thumb (de Quervain's disease), hip (iliotibial band tendinitis), knee (runner’s knee or peripatellar tendinitis), and lower calf or ankle (Achilles tendinitis). People with a chronic medical condition such as diabetes may have calcific tendinitis, a buildup of calcium deposits in the joint.

Acute (sudden onset) tendinitis may lead to chronic (long-term) tendinitis (called tendinosis or tendinopathy) if the person does not adequately rest the joint or if the person keeps using the joint while experiencing symptoms.

What Causes Tendinitis?

Repetitive strain injury (also called overuse injury) is the most common cause of tendinitis and may occur more commonly with certain occupations or sports (such as baseball, golf or tennis). It may also be associated with an inflammatory condition, such as rheumatoid arthritis, or may occur as the result of an acute injury, such as an excessive muscle stretch.

How Can Tendinitis be Prevented?

Stretching before and after an activity, cross-training, and avoiding activities that cause excessive stress on the tendons for long periods can help prevent or reduce the risk of tendinitis. Physical therapy that includes range-of-motion exercises as well as flexibility and strengthening exercises also may help reduce the risk of recurring tendinitis.

Finding a Massage Therapist

It is important to seek treatment from an experienced, licensed massage therapist who can assess your condition and recommend the massage techniques that are right for you. Most states regulate the massage therapy profession in the form of a license, registration or certification.

A variety of massage styles incorporate elements of cross fiber and active release techniques to relieve tendinitis. Ask your massage practitioner about their experience with these advanced manipulations for treatment.

Some important questions to ask the massage therapist, as recommended by the American Massage Therapy Association, include:

  • Are you licensed to practice massage?
  • How long have you been practicing massage?
  • Do you have experience in performing deep transverse friction massage for tendinitis?
  • Are you nationally certified in therapeutic massage and bodywork?
  • Are you a member of the American Massage Therapy Association?
  • Where did you receive your massage therapy training?

Additional Resources

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Medline information on Tendinitis.

Brosseu L, Casimiro L, Milne S, et al. Deep transverse friction massage for treating tendinitis. Cochrane Database of Systemic Reviews 2002 Issue 4. Art. No: CD003528.

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