Tendon problems are among the most common injuries caused by exercise. This week Asha Fowells considers what pharmacists and their teams can do for customers with tendonitis.

The symptoms of tendonitis are pain, tenderness and sometimes swelling at the point at which the tendon attaches to the bone

Any tendon of the body can develop tendonitis, not just the Achilles, which is the largest tendon in the body, but some areas are more prone

Many cases of tendonitis are minor and will resolve in a few weeks without medical treatment. In the short-term, following the principles of RICE (rest, ice, compression and elevation) can help limit the damage.

Sarah Grant calls into the pharmacy. She tells you that she decided a few months ago to try and start her forties fitter and stronger than she has been for many years and, having embarked upon and completed a Couch to 5k running programme, she now runs around 5k three times a week. Her left ankle has been hurting a little for the past couple of weeks, and while out running this morning, Sarah describes it as “really not feeling right” when she slowed to a walk . As she was close to the pharmacy at the time, she thought she’d pop in and ask whether she should try and “run it off” or rest it.

It sounds as though Sarah is suffering from tendonitis, inflammation of the tough but flexible tissue that connects the muscle to the bone, which is sometimes referred to as tendonosis or tendinopathy.

The Achilles tendon at the back of the ankle, which connects the calf muscle to the calcaneum bone in the heel of the foot, is a common source of injuries for runners, particularly when someone starts the sport after a prolonged period of inactivity in middle age.

This is partly due to the extra weight an individual is likely to be carrying at this point in life, but also because the tendon will not be as elastic and forgiving as it would have been in their younger days.

The symptoms of tendonitis are pain, tenderness and sometimes swelling at the point at which the tendon attaches to the bone.

The discomfort typically worsens upon movement, and the joint may feel weak or stiff. Tendonitis may occur abruptly or gradually worsen over time as a result of repeated microtraumas; shin splints are a common example of the latter.

Cases involving the Achilles tendon can be triggered by a change in training surface (for example, someone who has been running on paths suddenly switching to grass), wearing unsupportive footwear, overtraining or hill running. A runner with Achilles tendonitis is likely to suffer with pain when starting a run, which eases and then returns when they slow down. If left untreated, the pain may become constant.

Any tendon of the body can develop tendonitis, not just the Achilles, which is the largest tendon in the body, but some areas are more prone. The hands and wrists are one of the most common, for example repetitive strain injury as a result of keyboard use is a form of tendonitis, as is De Quervain’s tenosynovitis, which affects the part of the wrist nearest the thumb. Other common sites are the shoulder, the elbow (“tennis elbow” affects the outside of the joint, whereas “golfer’s elbow” involves the area around the inside), and the knee, which is usually precipitated by activities that involve jumping such as basketball and volleyball.

Come back tomorrow as we unravel what has caused Sarah’s tendonitis and how she can manage the pain.