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Understanding Tendinosis: Causes, Symptoms, and Treatment Options

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on May 28th, 2023.

Key Takeaways

  • This degenerative condition occurs when collagen fibers break down from repetitive microtrauma over months or years, unlike acute tendon injuries that involve inflammation.

  • Pain typically worsens with activity and improves with rest, often presenting as a dull ache that becomes sharp during movement—especially common in the lateral elbow (tennis elbow) and posterior heel.

  • Eccentric strengthening exercises, where muscles lengthen under tension, show 60-90% success rates and should be performed 2-3 times daily for 12-16 weeks to rebuild tendon structure.

  • Age-related changes after 30 reduce tendon blood supply and healing capacity, making weekend warriors particularly susceptible when dramatically increasing activity levels.

  • Corticosteroid injections may provide temporary relief but can weaken tendons long-term—platelet-rich plasma (PRP) therapy shows more promising results for tissue regeneration.

Tendinosis, also known as tendinopathy, is a condition that occurs when a tendon, which is a thick cord that connects bone to muscle, becomes inflamed or irritated. This condition can cause pain and discomfort in the affected area, making it difficult to perform daily activities or engage in physical exercise.

Causes of Tendinosis

Tendinosis is most often caused by repetitive, minor impact on the affected area or a sudden, more serious injury. Many activities can lead to the development of tendinosis, including:

  • Gardening

  • Raking

  • Carpentry

  • Cleaning house

  • Shoveling

  • Painting

  • Scrubbing

  • Playing sports like tennis, golf, skiing, or throwing and pitching

Other risk factors for tendinosis include incorrect posture at work or home, poor conditioning before exercise or playing sports, abnormal or poorly placed bones or joints, and stresses from other conditions like rheumatoid arthritis, gout, psoriatic arthritis, or thyroid disorders.

Symptoms of Tendinosis

The primary symptom of tendinosis is pain at the site of the tendon and the surrounding area. The pain may gradually build up or be sudden and severe, especially if calcium deposits are present. In some cases, such as with shoulder tendinosis, you may experience a loss of motion, known as adhesive capsulitis or frozen shoulder.

Understanding Tendinosis: Causes, Symptoms, and Treatment Options

Common Locations of Tendinosis

Tendinosis can occur in almost any area of the body where a tendon connects a bone to a muscle. The most common places include:

  • Base of the thumb

  • Elbow

  • Shoulder

  • Hip

  • Knee

  • Achilles tendon

Treating Tendinosis

Initial treatment for tendinosis includes resting the injured area, avoiding activities that aggravate the problem, icing the area on the day of the injury, and taking over-the-counter anti-inflammatory drugs or using topical anti-inflammatory gels. If the condition does not improve within a week, it is essential to consult a doctor for more advanced treatments, such as:

  • Corticosteroid injections to quickly decrease inflammation and pain

  • Physical therapy, which can be particularly beneficial for frozen shoulder, and may include range-of-motion exercises and splinting

  • Surgery, which is rarely needed and only for severe problems not responding to other treatments

Recovery time for tendinosis varies depending on the severity of the injury, ranging from weeks to months. To prevent tendinosis, it is essential to gradually build up activity levels, use limited force and repetitions, and stop if pain occurs. If you experience fever, swelling, redness, warmth, general illness, multiple sites of pain, or an inability to move the affected area, consult a doctor immediately, as these could be signs of a more serious problem requiring immediate attention.

For more information on tendinosis, visit WebMD's guide to understanding tendinitis.

The Bottom Line

Recovery requires patience since tendons heal slowly due to poor blood supply, typically taking 3-6 months with consistent eccentric exercise protocols. Early recognition and proper treatment prevent chronic pain and potential tendon rupture. If you're experiencing persistent tendon pain that worsens with activity, Doctronic can help you understand your symptoms and next steps.

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