Tenosynovitis is the inflammation of the tendon sheath (synovium) surrounding a tendon, typically caused by repetitive friction, overuse, or infection. It leads to pain, swelling, and restricted movement in the affected area.
1. Tendons and Tendon Sheaths: Basic Anatomy
Tendon: A fibrous connective tissue that attaches muscle to bone, enabling joint movement (e.g., gripping, wrist extension).
Tendon Sheath: A protective synovial covering that reduces friction during tendon gliding (similar to a "sheath" around a "cable").
When tendons undergo repetitive motion or excessive load, the sheath becomes irritated, thickened, and inflamed, sometimes leading to adhesions.
2. Common Symptoms
Localized pain: Worsens with movement (e.g., wrist rotation, gripping).
Swelling or warmth: Possible redness and palpable nodules.
Stiffness/limited mobility: Joint may feel locked or "catch" (e.g., trigger finger).
Morning stiffness: Symptoms often flare after inactivity.
3. Common Types in Sports Medicine
De Quervain’s Tenosynovitis: Thumb-side wrist pain (common in racket sports, weightlifting).
Trigger Finger (Stenosing Tenosynovitis): Finger gets stuck in a bent position (frequent in climbers, gamers).
Intersection Syndrome: Forearm pain where wrist extensor tendons cross (seen in rowers, weightlifters).
Not Strictly Tenosynovitis but Related:
Tennis Elbow (Lateral Epicondylitis): Overuse of forearm extensors.
Golfer’s Elbow (Medial Epicondylitis): Overuse of forearm flexors.
4. Primary Causes in Athletes
Repetitive strain: High-frequency motions (e.g., serving in tennis, typing).
Acute overload: Sudden force or improper technique (e.g., deadlift with poor wrist alignment).
Chronic overuse: Poor ergonomics (e.g., cycling with excessive wrist pressure).
Systemic factors: Rheumatoid arthritis, diabetes, or infections (rare but serious).
5. High-Risk Sports & Activities
Racket sports (tennis, badminton, pickleball) → Wrist tenosynovitis.
Weightlifting/CrossFit → De Quervain’s, intersection syndrome.
Rock climbing → Flexor tendon sheath inflammation (A2 pulley strain).
Golf/baseball → Medial epicondylitis (golfer’s elbow).
Esports/musicians → Trigger finger, wrist tendinopathy.
6. Evidence-Based Treatment
Relative rest: Modify activity to avoid aggravating motions.
Ice/heat therapy: Ice for acute swelling; heat for chronic stiffness.
NSAIDs: Short-term use for pain/inflammation (e.g., ibuprofen).
Bracing/splinting: Thumb spica splint for De Quervain’s; finger splints for trigger finger.
Rehab exercises: Eccentric loading, tendon gliding drills.
Corticosteroid injections: For persistent cases (avoid frequent repeats).
Surgery: Tenosynovectomy or sheath release if conservative measures fail.
Prevention Strategies for Athletes
✅ Technique optimization: Coach-assisted form checks (e.g., wrist position in snatches).
✅ Gradual progression: Avoid sudden spikes in training volume.
✅ Ergonomic gear: Proper grip size (rackets, barbells), padded gloves (climbing).
✅ Prehab: Wrist/finger extensor strengthening, contrast baths.
Red flags: Persistent pain >2 weeks, crepitus, or signs of infection (fever, purulent swelling) → Refer to sports medicine specialist.
