• Dr. Justin Murray, PT, Cert. MDT

Tendinitis vs. Tendinosis - Similar words with vastly different treatments

Wikipedia defines a tendon as a “tough band of fibrous connective tissue that connect muscle to the bone and is capable of withstanding tension.” Tendons are made up of collagen and because of the frequency of loads and tensions that they undergo, are susceptible to injury and pain. Pain that is originating from a tendon can be mild to severe and can linger on for a significant amount of time, making these injuries potentially very frustrating. Early differentiation of the type of tendon injury that is present is critical in order to guide the treatment and also to prevent a lot of pain and frustration into the future.

The word tendinitis is a common word used in the medical field that most people are familiar with. Tendinitis refers to an acute inflammation of a tendon due to overloading. The big key here is that it is characterized by inflammation-meaning that further loading and stress can and likely will, make this condition worse by increasing the inflammatory response. Tendinitis has been shown to respond to the POLICE method-Protection, Off Loading, Ice, Compression and Elevation. Seeking early consultation from a physical therapist is beneficial in order to confirm the tendinitis diagnosis and also for education regarding this early treatment strategy. Once it is determined that the inflammatory response is over, the treatment may change to include some stretching and other loading strategies to ensure proper healing of the tendon.

Tendinosis is a term that is usually more unfamiliar to people. It is sometimes called “chronic tendinitis”, but this is very misleading. The major difference between tendinosis and tendinitis is that with tendinosis, there is no inflammation. Rather than inflammation at the tendon, there is actual structural tendon damage. This damage is usually in the form of small, micro tearing of the collagen. This creates pain with stretching and loading of the tendon. Because there is no inflammation present, the POLICE method mentioned above is not necessary. Patients with tendinosis can begin active treatment. Studies have shown that tendinosis responds very favorably to loading, specifically eccentric loading of the tendon. These loading strategies can remodel the tendon and return the tendon to its normal tensile strength and elasticity. Treatment times can vary, but generally we can expect this remodeling to happen in a 4-6-week period, allowing a patient to return to full function in under 8 weeks.

Our physical therapists have extensive training and will be able to determine the source of your pain. As mentioned above, early differentiation of tendon pain can be critical for proper treatment. Please call any of our offices to schedule an appointment with any of our Doctors of Physical Therapy to ensure that you don’t embark on an improper treatment path. Together, we can get those tendons back to normal and get you back to full function!

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