Dear GeezerJock Doc: I am 60 years old and have been swimming for the past 12 years. About a year ago, I started having pain in my right shoulder. An MRI showed tendonitis of the rotator cuff. I haven't been able to get rid of the problem. I stayed out of the pool for six weeks and I cut back my swimming time and took anti-inflammatories, to no avail. It doesn't hurt when I swim, but the next day I can feel it. Am I destined to have this forever? I love to swim! -- Jan Bartelt

The GeezerJock Doc responds:
Tendonitis is a very common problem among athletes. Tendons are the attachment point between the muscle and the bone; they anchor the muscle to the bone and are often the weak link. The tendon is at risk for injury because it is a tissue with a very poor blood supply. For this reason, these injures often can linger and are very difficult to treat.

Here are some of the most common forms of tendonitis:

• Achilles: common in runners and jumpers
• Elbow: common in throwers, tennis players and golfers (the injury can affect the tendons on either side of the elbow)
• Shoulder: common in lifters, throwers and swimmers

Often these injuries are the result of overuse, which can be from a host of causes. Changes in a person's training may lead to an overuse injury. Increasing the frequency, intensity or volume of work may cause an injury to the tendon.  Changes in equipment or environment may lead to injury. These changes can be as subtle as a change in the sport surface. Using worn or outdated equipment also may be a factor.

The following are some basic guidelines to treatment:

• Attempt to identify the cause and correct it. 
• Stretch the area above the tendon and the muscles around it. If, for example, one is suffering from Achilles' tendonitis, it is very important to stretch the calf muscles. Having tight muscles will pull on the tendon, often creating the tendonitis.
• Decrease your workload while giving the inflammation in the tendon a chance to heal.
• Consider the use of non-steroidal anti-inflammatory medications, such as over the counter Ibuprofen or Aleve.
• Strengthen the muscles that support the hurting tendon once the inflammation has begun to subside. For example, our questioner, who is suffering from rotator cuff tendonitis, should work on strengthening the muscles around the shoulder with weights and bands.

If after several weeks or months there is no improvement, an athlete should consult his or her health professional for further treatment.