Tendinosis

Medically Reviewed by Shruthi N, MD on July 09, 2024
Written by Timothy Gower
8 min read

Tendinosis (also called tendinopathy) is an inflammation or irritation of a tendon, a thick cord that attaches bone to muscle.

Tendinosis happens when collagen that forms a tendon breaks down and degenerates over time. Overuse of a tendon is a common cause, which can become chronic if the injury isn’t allowed to heal. Tendinosis can occur in any part of the body, but commonly affects the elbow, forearm, wrist, shoulder, heel, and knee.

When tendons become damaged, the blood vessels that can help collagen heal can be affected, which may lead to hypersensitivity and pain.

Common causes of tendinosis include dealing with an acute injury, overuse of a tendon, or the way you position yourself when performing tasks like typing at your keyboard. 

Tendinosis is most often caused by repetitive muscle movements, minor impact on the affected area, or from a sudden, more serious injury.

Many activities can cause tendinosis, including:

  • Gardening
  • Raking
  • Carpentry
  • House cleaning
  • Shoveling
  • Painting
  • Scrubbing
  • Tennis
  • Golf
  • Skiing
  • Throwing and pitching

Other risk factors include:

  • Poor posture
  • Bone or joint abnormalities (such as length differences in your legs or arthritis in a joint) that can place stress on tendons
  • Stresses from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, and thyroid disorders, or unusual medication reactions
  • Overuse or doing too much, too soon when your tendons aren’t used to making a movement or doing a task. Tendinosis is common in “weekend warriors," people who play and exercise hard only on weekends.
  • Occasionally an infection can cause tendinosis, especially if it’s caused by a cat or dog bite to the hand or a finger
  • Arthritis
  • Psoriatic arthritis, which is a condition that can cause skin changes (called psoriasis) and joint inflammation. The most common symptoms you may notice are throbbing pain and stiffness over the tendons of your fingers, hands, and toes.

Who gets tendinosis?

Anyone can get tendinosis, but it’s more common in adults, especially people over age 40. As tendons age, they tolerate less stress, become less elastic, and tear more easily. 

Other people at risk for developing tendinosis include:

Certain workers and athletes. If your job or hobby requires you to make the same muscle movement over and over, you may be at risk for tendinosis. Computer programmers, assembly line workers, and professional athletes (such as tennis players) have high rates of this condition.

People with obesity. If you’re overweight or obese, excess pounds can place more stress on your tendons.‌

Some medication users. Certain medications may cause you to develop tendinosis, including some antibiotics.‌

Tendons that are most subject to overuse and the development of tendinosis include:

  • Common extensor tendons located on the outside of your elbow
  • Rotator cuff tendons found alongside your shoulder socket
  • Gluteal tendons located on the outside of your hip
  • Achilles tendons found in the back of your heel
  • Patellar tendons connecting your kneecap to your shin bone‌

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

  • Base of the thumb
  • Elbow
  • Shoulder
  • Hip
  • Knee
  • Achilles tendon

Patellar tendinosis

Many aching knees diagnosed as patellar tendonitis, or jumper’s knee, are actually patellar tendinosis. (Tendonitis is a condition caused by inflammation, not breakdown of collagen, though it can become chronic and develop into tendinosis.) This condition affects the tendons that connect your kneecap to your shin. These tendons get strained anytime you leap and land, take off running or stop suddenly, or make a sharp cutting move when you're on the move. Long hours of hard fitness training can put strain on these tendons, too. Some other potential causes of patellar tendinosis include:

  • Loose ligaments (tissues that connect bone to bone)
  • Tight quadriceps or hamstrings
  • High arches
  • Exercising on hard surfaces
  • Being overweight or carrying too much belly flab

Rotator cuff tendinosis

If you play a lot of tennis or lift weights, you may have experienced rotator cuff tendinosis. Each of your shoulders has four rotator cuff muscles. The tendons that attach these muscles to bone can be injured by repetitive motions, especially moving your arms overhead. That’s why certain professions, such as carpentry and house painting, can increase the risk for rotator cuff tendinosis, too. This condition not only causes pain and weakness, but you may find it hard to raise your arm higher than your shoulder. Supraspinatus tendinosis, which affects a muscle in the upper shoulder, is one form of rotator cuff tendinosis. 

Other types of tendinosis

Some other forms of tendinosis include:

  • Achilles tendinosis, a form of injury to the thick tendon that supports muscles in the lower rear of your leg
  • Biceps tendinosis, which may be caused by repetitive overhead motions or aging
  • Hamstring tendinosis, a painful condition that you feel in the thigh and hip 
  • Lateral elbow tendinosis, better known as tennis elbow
  • Peroneal tendinosis, affecting tendons on the outside of the ankle
  • Gluteal tendinosis, which can cause severe pain in the outside part of your hips

The symptoms of tendinosis include:

  • Pain at the site of the tendon and surrounding area. Pain may gradually build up or be sudden and severe, especially if calcium deposits are present.
  • Loss of motion in the shoulder, called "adhesive capsulitis" or frozen shoulder.

 

To avoid tendinosis, try these tips when performing activities:

  • Take it slow at first. Gradually build up your activity level.
  • Use limited force and limited repetitions.
  • Stop if pain occurs. Do something else. Try again later and if pain recurs, stop that activity for the day.

If you have tendinosis, at-home treatments may help relieve the symptoms, including:

  • Resting the injured area
  • Applying an ice pack to the injured tendon
  • Taking over-the-counter anti-inflammatory drugs or using topical anti-inflammatory gels
  • Avoiding activities that aggravate the problem

If your symptoms don’t improve in a week, see your doctor. After performing a physical examination, they may refer you to a specialist for more advanced treatments, which could include:

Corticosteroid injections. Doctors often recommend corticosteroids (often called simply “steroids”) because they work quickly to decrease inflammation and pain.

Physical therapy. Working with a physical therapist (PT) can be very beneficial, especially for a frozen shoulder. A PT can help you regain strength and mobility, and may recommend splints to stabilize your tendon while it heals.

Platelet-rich plasma. In this treatment, you will have a small amount of blood drawn, which is sent to a lab. Small cells called platelets are removed from the blood and injected back into your body with the goal of promoting healing. 

Surgery. In rare cases, surgery may be necessary to treat severe tendinosis that doesn’t respond to other treatments.

Tendinosis may take weeks to months to go away, depending on the severity of your injury.

You should see your doctor if you experience any of the following:

  • Fever (over 100 degrees Fahrenheit)
  • Swelling, redness, and warmth
  • General illness or multiple sites of pain
  • Inability to move the affected area

These could be signs of another problem that needs more immediate attention.

 

 

Tendinosis doesn’t have to leave you on the sidelines. Making some adjustments can help you live a full, satisfying life while you manage this chronic tendon condition, including the following:

Change your environment. If your job caused your tendinosis or is making it worse, changing your work environment may help. For example, if typing all day is straining the tendons in your wrists, neck, and elsewhere, look into buying an ergonomically designed desk, chair, keyboard, and other equipment, which reduce strain brought on by hours of sitting. 

Be kind to your body. Build frequent breaks into your daily routine.

Check your technique. Improper technique in sports can strain muscles and tendons, so ask a trainer or experienced athlete to watch you while you work out and correct any potentially harmful flaws in your movement.

Do a med check. If you think it’s possible that a medication you’re taking may be causing tendon problems, talk with your doctor about alternatives.

Speak up. Tell your doctor if your tendinosis symptoms get worse. 

Tendinosis is a chronic condition that causes pain and other symptoms, but it doesn’t have to keep you from doing your job or enjoying sports and other pastimes you love. The symptoms of tendinosis often respond well to simple at-home treatments. If your tendinosis symptoms don’t go away after a few weeks, your doctor may be able to recommend other effective treatments or refer you to a physical therapist. 

Is tendinosis permanent?

Tendinosis can become a chronic, or long-term, condition. However, with proper treatment, damaged collagen can rebuild and your tendon can return to normal. 

Is tendinosis worse than tendonitis?

Neither condition is worse than the other. Tendinosis and tendinitis can both cause significant pain and other symptoms. 

What can tendinosis lead to?

Tendinosis responds well to rest and other treatments. But if you don’t get treatment, your tendinosis can worsen. Over time, your tendon may rupture, requiring surgery. 

Is tendinosis the same thing as bursitis?

No, tendinosis and bursitis are related, but different, conditions. Tendinosis occurs when the collagen that forms tendons breaks down. Bursitis occurs when small fluid-filled sacs called bursa that cushion tendons, as well as muscles, become inflamed. 

Should you massage tendinosis?

A massage by a licensed massage therapist can help ease the pain and promote healing of tendinosis. 

How long does tendinosis last?

Complete healing of tendinosis can take 3 to 6 months, but rest and proper treatment can help speed up your recovery. 

Does compression help tendinosis?

Compression is not typically recommended for tendinosis. However, splints or braces may help stabilize a tendon as it heals. 

Is heat good for tendinosis?

Experts usually recommend applying ice packs to treat tendinosis, though they’re not sure why it helps. You can place an ice pack on the affected tendon for 15 to 20 minutes a few times a day. Ice helps after you have performed any activity that uses the tendon, too.