Tendonitis or Tendinosis? What Is the Difference and Why It Matters for Your Recovery
Tendonitis: “inflammation or irritation of a tendon — any one of the thick fibrous cords that attaches muscle to bone. The condition causes pain and tenderness just outside a joint. While tendinitis can occur in any of your body’s tendons, it’s most common around your shoulders, elbows, wrists, knees and heels.”
Tendinosis (Tendinopathy): “a degenerative injury to the tendon that doesn’t provoke an immune response. It occurs when repetitive, unrelenting stress over time causes the breakdown of collagen, growth of abnormal blood vessels, and thickening of the tendon’s sheath (covering).”
Chances are you’ve heard of tendonitis — it’s commonly blamed for joint discomfort of varying severity. Whether it’s said to be “flaring” or “acting” up, tendonitis gets a bad rap.
But here’s the thing, tendonitis is actually quite rare (and not a big deal). Most people don’t do nearly enough physical activity to induce tendonitis. In fact, research suggests that many injuries diagnosed as tendonitis are actually tendinosis (or tendinopathy).
The difference may not seem significant to you, but I want to posit that the language we use to describe the ailments facing our body can matter a great deal with how we treat them. Using a term too loosely can change the entire course of a conversation and incorrectly frame how the problem should be addressed.
In this post, I’m going to share the difference between tendonitis and tendinosis. This should help you better diagnose the underlying condition causing any joint discomfort you may have. While the pain each condition causes has similarities, they require vastly different approaches to treatment.
Tendonitis is a short term issue. The discomfort in the joint is caused by inflammation from the body’s immune response to an acute overload of a tendon. As a result, most movement is bothersome.
Tendonitis is best treated with ice, rest, and NSAIDs (nonsteroidal anti-inflammatory drugs like Advil or Ibuprofen).
Tendinosis is a long term issue that causes recurring and chronic pain. Unlike tendonitis, there is no inflammation because tendinosis doesn’t trigger an immune response. The nagging pain is instead caused by cellular damage to the tendon. The condition doesn’t typically inhibit motion.
Tendinosis is best treated with heat, movement therapy, corrective exercise, and friction massage.
Now you see why it matters. The two conditions are treated in complete opposite ways: confusing one for the other will actually cause you to exacerbate the issue.
Tendonitis rarely occurs, but is commonly diagnosed. Tendinosis is common, but rarely diagnosed.
Tendinosis is an RSI (repetitive strain injury). It happens over a long period where the tendon receives small but significant abuse repeatedly. It is chronic by nature and can take months or even years to heal, particularly if it is not identified and treated properly.
How to Tell the Difference
If you can recall a specific event that caused the start of the pain, it is more than likely tendonitis. Tendonitis is more common if you are a competitive athlete, crossfitter, or weight lifter.
When you move, how intense is the pain? If the pain is high, it’s more likely to be tendonitis. If the pain is lower, tendinosis.
Tendonitis should go away in about 14 days if treated properly. It is also often warm to the touch as result of the inflammation, and will respond well to anti-inflammatory drugs.
Tendinosis nags over and over up and down, more annoying than anything, however it tends to be progressive. It will not respond well to NSAIDs or ice — it needs heat.
Tendonitis should be left to rest. Only once pain is alleviated may you return to your regularly scheduled programming.
Tendinosis requires corrective intervention from hands-on training and therapeutic modalities.
Know the difference and treat your discomfort appropriately.
Still not sure? Come in for a fitness evaluation and one of our trainers will help diagnose your condition, and if appropriate, develop a fitness plan that either keeps you from overloading your tendons (tendonitis) or alleviates nagging cellular damage (tendinosis).