Tendonitis vs. Tendinosis: How to Treat

Tendon pain can be confusing and frustrating, especially when you’re trying to understand a diagnosis or are doing research online. Two terms commonly thrown around are “tendonitis” (or “tendinitis”) and “tendinosis.” While they sound similar, they refer to different conditions, and knowing the difference can make a big impact on your recovery.

Whether you just started experiencing sharp, occasional pain or have been dealing with longer-term symptoms, understanding tendonitis vs. tendinosis can help you better communicate with your physical therapist and take control of your healing process.

What is tendonitis?

Tendonitis is an acute condition characterized by inflammation in a tendon. Tendons are the thick, fibrous tissues that connect muscle to bone, and they can become irritated if subjected to overuse or sudden injury. Perhaps the most well-known type of tendonitis is Achille’s tendonitis, which affects the tendon in the heel.

Tendonitis is often temporary and can usually be managed through rest and self-care for most individuals.

• Cause: Tendonitis usually occurs due to repetitive strain or sudden increases in activity, like overdoing it at the gym or spending the whole day cleaning out the garage.
• Symptoms: Common signs of tendonitis include swelling, localized pain (either sharp or throbbing), warmth, and tenderness around the affected tendon.

What is tendinosis?

Tendinosis, on the other hand, is a chronic condition that develops when a tendon has been repeatedly overused or not given enough time to heal after an injury. Unlike tendonitis, tendinosis isn’t primarily about inflammation but involves degeneration of the tendon tissue over time. Medically, tendinosis is treated differently because it reflects a different issue than the temporary inflammation seen in tendonitis.

Symptoms of tendinosis

Tendinosis often looks highly similar to tendonitis, but a few symptoms that stand out include:

• Stiffness: Tendons affected by tendinosis may feel stiff, especially first thing in the morning or after a period of rest.
• Thickening: The affected tendon may look or feel thicker than normal.
• Pain: Unlike the sudden, acute pain from tendonitis, tendinosis can cause a dull, aching pain that worsens with prolonged or repetitive activity.
• Weakened functionality: Over time, tendons affected by tendinosis may lead to reduced strength and flexibility.

Because tendinosis develops gradually and isn’t associated with inflammation, attempting to treat it with Advil or ice alone is generally ineffective. Addressing tendinosis often requires a more tailored plan to rehabilitate the degeneration of collagen in the tendon.

How to treat tendonitis and tendinosis

While the basic goal for healing both conditions is restoring the tendon to good health, the approach for each is different, which highlights the importance of knowing which condition you’re suffering from.

Treating tendonitis

• Rest and ice: Reducing activity and icing the area (15-20 minutes at a time, several times a day) helps with inflammation.
• Compression & elevation: Wrapping the area with a compressive sleeve or bandage can reduce swelling, and keeping it elevated also helps manage inflammation.
• Gentle stretching: Once the pain starts to subside, gentle stretching and strengthening exercises can aid recovery and prevent future injuries.
• Modify activities: Identify the activity that caused the issue and modify how you do it or avoid it altogether while you recover.

Treating tendinosis

• Rest: Similar to tendonitis, rest is key to allow the body to heal itself. Stopping or greatly reducing any activities that aggravate your pain is recommended, although not always possible.
• Gentle exercise: Light stretching and a few specific strength-building exercises, such as eccentric loading (lengthening muscle while bearing weight), have been shown to help rebuild tendons over time.
• Soft tissue therapy: Approaches like massage or ultrasound therapy can stimulate blood flow and aid healing when performed by a professional.
• Professional guidance: Tendinosis often requires specific therapeutic treatments that target the degenerative changes in the tendon, so consulting a physical therapist is highly recommended.

Remember, progress with tendinosis may take longer since it’s a chronic condition. Consistency and patience are key.

When to see a physical therapist

Not sure whether you’re dealing with tendonitis or tendinosis? That’s okay. If you’ve been trying to treat a joint injury and aren’t seeing any relief, even if you’re sure it’s one or the other condition, we’re here to help. Here’s when you should reach out to a physical therapist:

• Severe or persistent pain: If the pain prevents you from carrying out everyday activities or keeps you up at night, it’s time to get professional advice.
• No improvement: If tendonitis symptoms don’t improve after a couple of weeks of rest and care, or if your tendinosis symptoms seem to be worsening, seeking support can offer clarity and relief.
• Recurrent issues: If you’re experiencing recurring tendon problems, a physical therapist can help identify underlying causes and create a tailored plan to strengthen your tendons and prevent future injuries.

A PT will assess your condition, recommend a personalized recovery plan, and guide you through safe exercises tailored to restoring your tendon health. Advanced treatments like manual therapy, dry needling, or blood flow restriction training may also be part of your recovery strategy.

Physical therapy in SW Michigan

If you’re experiencing tendon pain or need guidance in managing tendonitis or tendinosis, the experts at Armor Physical Therapy are here to help. With clinics located throughout southwest Michigan, including Battle Creek, Kalamazoo, and Portage, we specialize in treatments that get you back to doing what you love—pain-free.

Start a conversation with our team by calling a nearby clinic or by requesting an appointment online today.