Table of ContentsView AllTable of ContentsAnatomyFunctionConditionsRehabilitation
Table of ContentsView All
View All
Table of Contents
Anatomy
Function
Conditions
Rehabilitation
A tendon sheath, which is a thin layer of tissue, surrounds eachtendonin the body. The tendon sheath can also be called synovial lining or fibrous sheath.
Overuse and traumatic injuries can cause pain or swelling of the tendon sheath. Treatment may involve physical rest and/or additional treatment, such as medication,physical therapy, or surgery.
This article discusses the anatomy and function of tendon sheaths, along with several conditions that can affect them. It also covers how these conditions may be treated.
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Tendon Sheath Anatomy
Tendons are strong, thick structures that connect muscles and bones to each other. They can withstand a degree of stretching and turning as the bones and muscles maneuver.
Tendon sheaths, like tendons, are a type of connective tissue. This means that they interact with other types of body tissues rather than functioning on their own.
Synoviumis connective tissue that lines the structures in the body’s joints. A tendon sheath is a type of synovium that specifically lines tendons.
Structure
A tendon sheath is quite thin, but it is composed of a few layers of connective tissue—fibrous and synovial layers. The fibrous layer is supportive and protective; The synovial layer lines the tendons and produces synovial fluid.
Both of these layers are flexible and they move as the tendons move. Synovial fluid flows within the tissue layers of a tendon sheath.
Location
Tendon sheaths are located around tendons, which are found in joints throughout the body, including the hands, arms, shoulders, legs, and feet.
Joints are complex, moveable structures composed of several types of tissue: bones,cartilage, muscles, tendons, and ligaments (which connect muscles to each other), as well as their supportive lining tissues, such as tendon sheaths.
The Role of Joints in Your Body
Tendon Sheath Function
The tendon sheaths protect the tendons when they are at rest and when they move. They prevent tendons from adhering to surrounding structures and they protect them from damage that could occur with repetitive movements.
Tendon Sheath Conditions
There are several conditions that can affect a tendon sheath. These ailments are associated with inflammation, which is swelling due to a proliferation of fluid and immune cells. Inflammation can occur in and around a tendon sheath as the result of injuries, overuse, or disease.
Tenosynovitis
Tenosynovitisis inflammation of the tendon sheath. It usually becomes noticeable at a relatively early stage, when it can be treated.
What does inflamed tendon sheath feel like?When the tendon can’t slide smoothly through the sheath, movement results in a rubbing or grinding feeling.
What does inflamed tendon sheath feel like?
When the tendon can’t slide smoothly through the sheath, movement results in a rubbing or grinding feeling.
de Quervain’s Tenosynovitis
Arthritis
Tendonitis
Tendonitisoccurs when the tendon becomes inflamed. A tendon can be inflamed due to an overuse injury. This inflammation can also affect the tendon sheath.
How Inflammation Causes Tendonitis
Infection
An infection can contaminate a tendon and/or tendon sheath. This is not common and is usually due to severe trauma involving an open wound or an immune deficiency (a weak immune system).
Fibrous Nodule
A fibrous nodule (also called a fibroma) is thickening of the tendon or the tendon sheath. It may cause swelling, a lump, or discomfort.
Giant-Cell Tumor
Agiant-cell tumor of the tendon sheathis a benign (not harmful) growth along the tendon sheath. It isn’t completely clear why they develop, but it is thought to result from overuse and wear and tear.
Treatment for Mild to Severely Locked Trigger Finger
Tendon Sheath Treatment
There are several treatments for conditions that affect the tendon sheath. Resting the affected joint and placing ice on it to reduce the swelling is often effective.
A brace can prevent overuse, which can help your joint, tendon, and tendon sheath recover.
If there is a severe injury, surgery may be necessary to repair the joint and allow the tendon sheath and other structures to heal. If you have had a major injury to your tendon and/or tendon sheath, you may also benefit from physical therapy or occupational therapy to build your strength and learn how to avoid movements that could cause further injury.
Summary
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peters S, Jha B, Ross M.Rehabilitation following surgery for flexor tendon injuries of the hand.Cochrane Database Syst Rev. 2021 Jan;2021(1):CD012479. doi:10.1002/14651858.CD012479.pub2Challoumas D, Ramasubbu R, Rooney E, et al.Management of de Quervain tenosynovitis.JAMA Netw Open. 2023;6(10):e2337001. doi:10.1001/jamanetworkopen.2023.37001Cedars Sinai.Tendonitis and Tenosynovitis.Rogier C, Hayer S, van der Helm-van Mil A.Not only synovitis but also tenosynovitis needs to be considered: Why it is time to update textbook images of rheumatoid arthritis.Ann Rheum Dis. 2020 Apr;79(4):546–547. doi:10.1136/annrheumdis-2019-216350Sutardi G, Chaidir D, Ismiarto Y.Progressive flexor tendon sheath infection on hand after needle puncture during surgery: A case report.J Med Case Rep. 2022;16(1):373. doi:10.1186/s13256-022-03525-1Suzuki K, Yasuda T, Suzawa S, Watanabe K, Kanamori M, Kimura T.Fibroma of tendon sheath around large joints: clinical characteristics and literature review.BMC Musculoskelet Disord. 2017;18(1):376. doi:10.1186/s12891-017-1736-5Minotto R, Rodrigues C, Grill A, Furian R.Giant cell tumor of the tendon sheath: A rare periungual location simulating myxoid cyst.An Bras Dermatol. 2017 Feb;92(1):121-123. doi:10.1590/abd1806-4841.20175229Webb N, Bravman J, Jensen A, Flug J, Strickland C.Arthrographic anatomy of the biceps tendon sheath: Potential implications for selective injection.Curr Probl Diagn Radiol. 2017;46(6):415-418. doi:10.1067/j.cpradiol.2017.02.002
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peters S, Jha B, Ross M.Rehabilitation following surgery for flexor tendon injuries of the hand.Cochrane Database Syst Rev. 2021 Jan;2021(1):CD012479. doi:10.1002/14651858.CD012479.pub2Challoumas D, Ramasubbu R, Rooney E, et al.Management of de Quervain tenosynovitis.JAMA Netw Open. 2023;6(10):e2337001. doi:10.1001/jamanetworkopen.2023.37001Cedars Sinai.Tendonitis and Tenosynovitis.Rogier C, Hayer S, van der Helm-van Mil A.Not only synovitis but also tenosynovitis needs to be considered: Why it is time to update textbook images of rheumatoid arthritis.Ann Rheum Dis. 2020 Apr;79(4):546–547. doi:10.1136/annrheumdis-2019-216350Sutardi G, Chaidir D, Ismiarto Y.Progressive flexor tendon sheath infection on hand after needle puncture during surgery: A case report.J Med Case Rep. 2022;16(1):373. doi:10.1186/s13256-022-03525-1Suzuki K, Yasuda T, Suzawa S, Watanabe K, Kanamori M, Kimura T.Fibroma of tendon sheath around large joints: clinical characteristics and literature review.BMC Musculoskelet Disord. 2017;18(1):376. doi:10.1186/s12891-017-1736-5Minotto R, Rodrigues C, Grill A, Furian R.Giant cell tumor of the tendon sheath: A rare periungual location simulating myxoid cyst.An Bras Dermatol. 2017 Feb;92(1):121-123. doi:10.1590/abd1806-4841.20175229Webb N, Bravman J, Jensen A, Flug J, Strickland C.Arthrographic anatomy of the biceps tendon sheath: Potential implications for selective injection.Curr Probl Diagn Radiol. 2017;46(6):415-418. doi:10.1067/j.cpradiol.2017.02.002
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Peters S, Jha B, Ross M.Rehabilitation following surgery for flexor tendon injuries of the hand.Cochrane Database Syst Rev. 2021 Jan;2021(1):CD012479. doi:10.1002/14651858.CD012479.pub2Challoumas D, Ramasubbu R, Rooney E, et al.Management of de Quervain tenosynovitis.JAMA Netw Open. 2023;6(10):e2337001. doi:10.1001/jamanetworkopen.2023.37001Cedars Sinai.Tendonitis and Tenosynovitis.Rogier C, Hayer S, van der Helm-van Mil A.Not only synovitis but also tenosynovitis needs to be considered: Why it is time to update textbook images of rheumatoid arthritis.Ann Rheum Dis. 2020 Apr;79(4):546–547. doi:10.1136/annrheumdis-2019-216350Sutardi G, Chaidir D, Ismiarto Y.Progressive flexor tendon sheath infection on hand after needle puncture during surgery: A case report.J Med Case Rep. 2022;16(1):373. doi:10.1186/s13256-022-03525-1Suzuki K, Yasuda T, Suzawa S, Watanabe K, Kanamori M, Kimura T.Fibroma of tendon sheath around large joints: clinical characteristics and literature review.BMC Musculoskelet Disord. 2017;18(1):376. doi:10.1186/s12891-017-1736-5Minotto R, Rodrigues C, Grill A, Furian R.Giant cell tumor of the tendon sheath: A rare periungual location simulating myxoid cyst.An Bras Dermatol. 2017 Feb;92(1):121-123. doi:10.1590/abd1806-4841.20175229Webb N, Bravman J, Jensen A, Flug J, Strickland C.Arthrographic anatomy of the biceps tendon sheath: Potential implications for selective injection.Curr Probl Diagn Radiol. 2017;46(6):415-418. doi:10.1067/j.cpradiol.2017.02.002
Peters S, Jha B, Ross M.Rehabilitation following surgery for flexor tendon injuries of the hand.Cochrane Database Syst Rev. 2021 Jan;2021(1):CD012479. doi:10.1002/14651858.CD012479.pub2
Challoumas D, Ramasubbu R, Rooney E, et al.Management of de Quervain tenosynovitis.JAMA Netw Open. 2023;6(10):e2337001. doi:10.1001/jamanetworkopen.2023.37001
Cedars Sinai.Tendonitis and Tenosynovitis.
Rogier C, Hayer S, van der Helm-van Mil A.Not only synovitis but also tenosynovitis needs to be considered: Why it is time to update textbook images of rheumatoid arthritis.Ann Rheum Dis. 2020 Apr;79(4):546–547. doi:10.1136/annrheumdis-2019-216350
Sutardi G, Chaidir D, Ismiarto Y.Progressive flexor tendon sheath infection on hand after needle puncture during surgery: A case report.J Med Case Rep. 2022;16(1):373. doi:10.1186/s13256-022-03525-1
Suzuki K, Yasuda T, Suzawa S, Watanabe K, Kanamori M, Kimura T.Fibroma of tendon sheath around large joints: clinical characteristics and literature review.BMC Musculoskelet Disord. 2017;18(1):376. doi:10.1186/s12891-017-1736-5
Minotto R, Rodrigues C, Grill A, Furian R.Giant cell tumor of the tendon sheath: A rare periungual location simulating myxoid cyst.An Bras Dermatol. 2017 Feb;92(1):121-123. doi:10.1590/abd1806-4841.20175229
Webb N, Bravman J, Jensen A, Flug J, Strickland C.Arthrographic anatomy of the biceps tendon sheath: Potential implications for selective injection.Curr Probl Diagn Radiol. 2017;46(6):415-418. doi:10.1067/j.cpradiol.2017.02.002
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