Tendinosis is a chronic tendon injury. It is a common condition but is often misdiagnosed as tendinitis.

In this article, learn about the symptoms, causes, and treatments for tendinosis, as well as what makes it different from tendinitis.

What is tendinosis?

Tendons are the tough, fibrous cords that attach muscles to bones. Healthy tendons are made of straight, parallel fibers of collagen.

Tendinosis occurs when tendons degenerate, meaning that they begin to break down. Tendons may have small tears or disorganized collagen fibers instead of straight collagen fibers.

This condition is most common in the elbow, shoulder, knee, hip, and Achilles heel tendons.

Tendinosis may be linked to other underlying conditions, such as tennis elbow and swimmer's shoulder.

Symptoms

Tendinosis refers to hardening, thickening, and scarring of the tendons. This causes pain and a loss of flexibility in the joint.

Common symptoms of tendinosis are:

• localized burning pain and swelling around the tendon
• pain that gets worse during and after activity
• stiffness in the joint
• restricted joint movement
• pain that persists for several months

Causes

Tendinosis is usually caused by an overuse of the tendon. It can also be caused by physical trauma, such as a fall or sports injury.

Hobbies or professions that require putting repeated stress on the tendons can cause tendinosis. Athletes and manual laborers, for example, are more prone to this disorder.

Tendon problems are more common in older adults because the joints become less flexible as a person ages. People with joint conditions such as arthritis may also be more prone to tendinosis.

Treatment

Tendons usually take a long time to heal, so the treatments for tendinosis aim to speed up the body's natural healing processes.

Doctors often recommend the following at-home treatments:

• Resting the tendon and avoiding repetitive movements. This may include taking a break every 15 minutes when doing repetitive activities, such as typing.
• Stretching the tendon to increase its range of movement and flexibility and to promote circulation.
• Massaging the affected area to promote circulation.
• Strengthening the muscles around the tendon with exercises to reduce daily strain on the injured tendon.
• Using braces or tape to protect the tendon from further injury.

Initial research has also suggested that vitamin C and curcumin supplements may help to promote collagen production and speed up healing.

A doctor may also recommend the following treatments:

• Extracorporeal shockwave therapy (EWST), which involves applying pressure waves to the surface of the skin. This may promote the regeneration of tissue and speed up the healing process. EWST has been shown to be effective for some lower limb conditions.
• Surgery can remove damaged tissue to relieve pain and allow the tendon to heal.
• Corticosteroid injections around the tendon can reduce short-term pain and swelling. However, they may also make relapse more likely and can sometimes impair collagen production.
• Platelet-rich plasma (PRP) injections, involve injecting plasma from the person's blood into areas around the tendon. The platelets promote cell repair and healing.

Tendinosis vs tendinitis

Tendinosis and tendinitis both refer to problems with the tendons. They are often confused with one another, and the medical community is still working on defining these terms.

Tendinosis is a degeneration of tendon tissue, but may also involve some inflammation. Tendinosis is a chronic and long-term condition.

Tendinitis is tendon pain caused by inflammation. Symptoms can be relieved through anti-inflammatories and ice.

A doctor can often distinguish between tendinosis (degenerated tendons) and tendonitis (inflamed tendons) by scanning the affected area using an ultrasound or magnetic resonance imaging (MRI) scan.

Recovery time

Tendons take a long time to heal because the blood supply to tendons is typically low. Tendinosis may take 3 to 6 months to heal, but physical therapy and other treatments may improve the outlook.

A person who has tendinitis can expect a faster recovery time of up to 6 weeks.

Outlook

Although treatment can be difficult, the long-term outlook for tendinosis is good. Around 80% of people with tendinosis make a full recovery in 3 to 6 months, depending on whether their condition is chronic or not.

Tendinosis that is left untreated can lead to ruptured tendons so early treatment is crucial.

People can sometimes prevent tendinosis by ensuring they warm up thoroughly before exercise or beginning an activity involving repetitive joint movements. Wearing supportive shoes can protect tendons in the lower limbs.

Rest and physical therapy can speed up the recovery process and improve the long-term outlook for this condition.

—Amy Smith