Your skeletal structure is held in place by thousands of fibers that form tendons. The tendons attach the muscles to the bones and play a key role in all movements. Tendons and ligaments-which connect one bone to another can become irritated and inflamed as a result of overuse, repetitive stress, and injury, causing a condition known as tendinitis. Acute tendinitis may develop into a chronic condition if left untreated. The most commonly affected joints include the shoulder (rotator cuff tendinitis), the elbow (tennis elbow or golfer's elbow), the wrist and thumb, the knee, and the ankles (Achilles tendinitis). Metabolic disorders such as diabetes can cause calcified tendinitis, which occurs when calcium deposits build up in a joint. Symptoms of tendinitis include joint pain that gets worse with movement, swelling accompanied by warmth and redness, tenderness of the limb, and crackling sounds when moving the affected joint. Typical treatment involves anti-inflammatory and pain medication along with physical therapy and rest. In unresponsive cases, an orthopedic physician will most likely recommend cortisone injections to reduce inflammation. Known as painful obstruction syndrome, tendinitis in Chinese medicine represents blockage of energy and blood flow accompanied by dampness and heat in the affected joint and meridian system. The liver-gallbladder network is responsible for nourishing the tendons and joints of the body, so if this network is weakened as a result of emotional stress or toxic overload, the tendons become malnourished and prone to injury and damage. Tendons have much less blood supply than muscles, so tendon injuries are slower to heal than muscle injuries. We've found that tendinitis pain responds very well to acupuncture, as acupuncture can pinpoint where restored blood and energy flow are needed for healing a specific body part. With the addition of herbal therapy, I've treated many acute and chronic tendinitis conditions with excellent results. Our approach is to unblock the stagnation, promote the flow of energy and blood, strengthen the liver, and nourish the tendons and ligaments.