Understanding Tendonitis

Medically Reviewed by Jabeen Begum, MD on June 25, 2024
Written by Timothy Gower, WebMD Editorial Contributor
15 min read

Tendonitis is pain in or around a tendon, which is a band of strong tissue that connects a muscle to a bone. Tendons bend, stretch, and twist to help joints and muscles move. They can become inflamed and painful due to strain, overuse, or injury, resulting in tendonitis. 

You may hear your doctor call tendonitis by another term, overuse tendinopathy. Some common examples of overuse injuries that affect the tendons include Achilles tendinopathy of the ankle, rotator cuff tendonitis of the shoulder, and lateral epicondylitis, better known as tennis elbow.

Tendonitis can be very painful, and the discomfort can get stronger if you keep using the joint and damage to the tendon worsens. Tendonitis usually heals in about 2 to 4 weeks, but chronic tendontis can take more than 6 weeks, often because the patient doesn't give the tendon time to heal. If you have chronic tendonitis, you may not be able to move a joint fully due to scarring or because the sheath of tissue surrounding the tendon has narrowed. 

Tendonitis vs. tendinitis

Despite the slightly different spellings, tendonitis and tendinitis mean the same thing. Both refer to painful inflammation of the tendons. 

 

By far the most common cause of tendonitis is repeated stress -- using the same joints for the same stressful movements over and over again. That’s why serious athletes often develop tendonitis, though those who exercise less can develop sore tendons, too. Then again, any activity that requires the same movements over and over again can cause this painful problem. Your tendons are also more likely to become damaged if you’re not using the right equipment or exercising in poor conditions. What’s more, your tendons tend to lose their ability to stretch as you age. 

Risk factors

Tendonitis is a common problem that can affect just about anyone. Your risk increases as you age, since your tendons become less flexible and more vulnerable to injury. However, performing repetitive motions with the same muscles is a major risk factor for tendonitis, such as in:

  • Painting
  • Woodworking
  • Gardening or landscaping
  • Cleaning and janitorial work
  • Typing and other keyboard work
  • Tennis
  • Golf

You may also increase your risk for tendonitis if your posture is poor, you use the wrong technique (as in tennis or golf), or you’re wearing or using worn-out gear (such as old athletic shoes). 

If you have certain medical conditions, you may be more likely to develop tendonitis, including:

  • Diabetes
  • Osteoarthritis
  • Rheumatoid arthritis
  • Gout
  • An infection

Your risk may also increase if you use certain medications like:

  • Fluoroquinolones, a type of antibiotic
  • Corticosteroids 
  • Aromatase inhibitors, which are prescribed to lower breast cancer risk
  • Statin drugs, which lower cholesterol

Why am I getting tendonitis everywhere?

If you think you have tendonitis in many parts of your body, see a doctor soon. The pain caused by tendonitis can be similar to pain brought on by other medical conditions, so it’s important to get an accurate diagnosis in order to find the right treatment for you. 

You have about 4,000 tendons in your body, but some of them are more likely than others to develop tendonitis. Some common types of tendonitis include:

Wrist tendonitis

This form of tendonitis can happen when tissue surrounding tendons in the wrist become stressed due to overuse, which causes inflammation and pain. You might also find it hard to open a door or jar, for example, or lift a heavy object. Wrist tendonitis is more common in women and people whose jobs involve activities that require a lot of wrist movement, such as hair styling and typing.  

Calcific tendonitis

While tendonitis is often caused by stress on a tendon from repeated motions, that’s not always the case. Calcific tendonitis is caused by buildup of calcium on a tendon. You can develop calcific tendonitis anywhere in the body, but tendons in the shoulder are the most common place that calcium can collect. Calcific tendonitis may not cause symptoms, though it can cause severe pain and stiffness. 

Achilles tendonitis

The Achilles tendon, which is the largest tendon in your body, connects your calf muscles to your heel. This tendon is in action with every step you take, as well as when you stand on your toes or jump, so it’s no surprise that Achilles tendonitis is so common. Achilles tendonitis causes pain along the tendon and heel, which may be worse in the morning or after you've been active. Even putting on your shoe may hurt. 

Patellar tendonitis

Also known as jumper’s knee, patellar tendonitis affects the tendon connecting your kneecap to your shin. It’s a common problem for people who play a lot of sports that involve leaping and other movements that put pressure on the knees, such as basketball and volleyball. But anyone can develop patellar tendonitis, which can cause severe knee pain even while doing simple daily activities such as climbing stairs. 

Peroneal tendonitis

If you have ever sprained your ankle, you may have developed peroneal tendonitis, which affects the tendons connecting your lower leg to your foot.

Extensor tendonitis

You have extensor tendons in your hands and feet, which are critical for finger, toe, wrist, and ankle movement. Like many other forms of tendonitis, extensor tendonitis tends to happen in people who play sports or do other activities with a lot of repeated hand or foot movement. However, people with flat feet seem to be vulnerable, too. 

Posterior tibialis tendonitis

When you stand on your toes or push off from the ground when running or jumping, your posterior tibialis tendons are hard at work. These tendons connect the lower leg to the inner portion of your foot. When they become inflamed from overuse (such as sports that involve a lot of running, especially uphill), you may feel pain in the rear inside part of your ankle, or when standing on the ball of your foot or flexing your foot. Also, moving your foot may cause a cracking sound. 

Anterior tibialis tendonitis

This form of tendonitis is similar to posterior tibial tendonitis, only it affects a tendon in the front of the ankle, where it connects to the foot. Symptoms are similar, only the pain affects the forward portion of the ankle instead of the rear and may be worse when pulling the foot in an upward motion. 

Other types of tendonitis

There are several other forms of tendonitis, including:

  • Biceps tendonitis, also called rotator cuff tendonitis
  • Triceps tendonitis (uncommon)
  • Hip tendonitis
  • Lateral epicondylitis, better known as tennis elbow
  • Medial epicondylitis, often called golfer's or baseball elbow
  • DeQuervain's tenosynovitis, which affects the thumb
  • Trigger finger or trigger thumb, which is also a form of tenosynovitis

The most common symptoms of tendonitis include:

  • Pain when you use a muscle and flex a joint, such as taking a step, jumping, or picking up an object
  • A “grating” sensation when you move a joint
  • Tenderness
  • Swelling

Shoulder tendonitis symptoms

Shoulder tendonitis is a common problem, especially among people whose jobs involve a lot of overhead movements such as painting. Some common symptoms include:

  • Pain when you raise your arm
  • Stiffness and limited range of motion in the shoulder
  • Tenderness and swelling
  • Your shoulder “clicks” when you move it
  • Loss of strength in the shoulder

Doctors typically diagnose tendonitis by a physical exam alone. If you have symptoms of tendonitis, your doctor may order an ultrasound or MRI scans to help determine if a tendon is thickened, dislocated, or torn. But these tests are usually unnecessary for newly diagnosed cases. Your doctor may also assess whether you have similar problems, such as bursitis, which is inflammation of the fluid "cushion" surrounding the joints.

Tendonitis vs. tendinosis

Tendonitis and tendinosis are related, but different conditions that affect the tendons. Tendonitis occurs when a tendon becomes inflamed, which results in pain and stiffness. Tendonitis is generally caused by overuse of a tendon or an injury. Tendinosis happens when a tendon begins to degenerate and becomes thickened and scarred, which can be caused by aging, overuse, trauma, or osteoarthritis. 

The goals of treatment for tendonitis are to restore your ability to move the affected joint without pain and to help you maintain strength in the surrounding muscles while giving the tendon time to heal. Resting the tendon is key -- returning too soon to the activity that caused the injury in the first place can lead to chronic tendonitis (which your doctor may call overuse tendinopathy) and even cause tendons to tear.

As an immediate treatment for tendonitis, doctors and physical therapists often recommend the RICE program: rest, ice, compression, and elevation of the injured tendon. They may also suggest a short course of aspirin, ibuprofen, or other anti-inflammatory drugs to help relieve inflammation and pain. In some cases, your doctor may recommend injecting corticosteroids (a stronger anti-inflammatory drug) around the tendon to treat an acute injury, but this treatment is not used in chronic overuse tendinopathy due to its potential harmful side effects.

A physical therapist can suggest an exercise plan that rests the tendon while strengthening nearby muscle groups and maintaining overall muscle tone. Over time, it will be safe for you to exercise the tendon itself. Your program may include "eccentric" exercises, in which you slowly strengthen the muscle while stretching, stopping at the first sign of pain. Your physical therapist may also recommend easy stretching exercises for you to do several times a day.

Ultrasound and whirlpool treatments are useful for relaxing muscles and tendons, improving circulation, and promoting healing. For chronic tendonitis, options include open surgery and FAST (focused aspiration of scar tissue), which is ultrasound-guided and minimally invasive.

Tendonitis surgery

Tendonitis usually responds well to conservative treatments, but severe cases may require surgery. Some reasons that your doctor may recommend surgery for tendonitis include:

  • To realign tendons that are misaligned
  • To remove bone spurs, or growths on bones, which may be pressing against tendons and causing symptoms 
  • To remove calcium buildup, which can cause calcific tendonitis

The type of surgery you may need for tendonitis will depend on what tendon is affected. 

Extensor tendonitis treatment

You can usually treat extensor tendonitis with simple at-home treatments, which include resting the affected tendon, applying ice and compression with a bandage to reduce swelling, and keeping your hand or foot (whichever is affected) elevated above your heart when possible. Over-the-counter medications such as aspirin or ibuprofen may help ease pain and inflammation. If symptoms don’t fade within a few weeks, your doctor may suggest a corticosteroid injection, which reduces inflammation. Some patients with stubborn cases of extensor tendonitis benefit from physical therapy.

Tendonitis shoulder treatment

Doctors will typically recommend common treatments for tendonitis when this problem affects the shoulder, such as rest, ice packs, and bandage wraps. If your symptoms persist, you may benefit from corticosteroid injections to reduce inflammation and working with a physical therapist. Some doctors also recommend a treatment called plasma-rich platelet therapy (PPT) for treating shoulder tendonitis. Platelets are tiny cells that promote clotting in blood. In PPT, platelets are removed from your blood, treated, and injected back into you to promote healing. For shoulder tendonitis that involves tears in the rotator cuff or biceps, surgery may be necessary to repair the damaged tissue. 

Tendonitis of wrist treatment

Resting your wrist and avoiding the activity that caused you to develop tendonitis (such as typing) is critical. Applying ice and elevating your wrist frequently can help, too. So can a bandage wrap to reduce swelling or a wrist splint to keep the joint stable. In some cases, surgery may be needed to remove damaged tissue around the wrist or give a damaged tendon more room to move. A physical therapist can give you advice about how to avoid injuring your wrist again. 

Inflammation causes tendonitis, so doctors often recommend anti-inflammatory drugs such as ibuprofen to relieve symptoms. But if you're interested in natural, or non-medical, ways to reduce inflammation, the Institute for Natural Medicine recommends these: 

  • Contrast hydrotherapy. In this treatment, you switch from applying hot and cold to the affected tendon. Using hot and cold packs is an option, but contrast hydrotherapy may be more effective when you use cloths soaked in hot and cold water. The recommended method is to apply a hot wet cloth for 3 minutes, then switch to cold for 30 seconds. Continue this routine three times, and repeat several times a day. 

  • Herbal anti-inflammatories. Some herbal dietary supplements appear to reduce inflammation, including curcumin, turmeric, Boswellia, and ginger. Before taking any dietary supplement, ask your doctor if it’s safe.

  • Kinesiology taping. You may have seen athletes on TV wearing colorful tape stretched over their arms or legs. That’s kinesiology tape, and one reason athletes wear it is to prevent or reduce inflammation. There’s no evidence that it will have that effect in tendonitis, but it might be worth trying. 

  • Natural topical anti-inflammatories.You can buy an anti-inflammatory drug called diclofenac that’s applied to the skin over the counter, but if you prefer a natural treatment, capsaicin and menthol are options. 

Follow your doctor’s treatment instructions, which will likely be to follow the RICE program: rest, ice, compression (with a snug bandage), and elevation of the injured tendon. Taking anti-inflammatory medication such as ibuprofen may help, too. If you don’t feel better in a few weeks, check with your doctor about other treatments. 

When your symptoms go away, take steps to avoid getting tendonitis again, such as:

  • Stretch and warm up before you work out
  • Avoid activities that involve repetitive motions
  • During activities that you think could cause tendonitis, take frequent rest breaks 
  • Wear joint protection, such as wrist splints or ankle supports

There are other strategies that can help you live better with specific forms of tendonitis.

KT tape for patellar tendonitis

If you have patellar tendonitis, some trainers recommend using kinesiology tape, also known as KT tape. In theory, KT tape reduces inflammation and reduces pain, though whether you’ll get that benefit requires more research. 

Elbow tendonitis brace

Doctors and physical therapists often advise patients with elbow tendonitis to wear a forearm brace while working or playing sports. These braces apply pressure to the forearm, which reduces pressure on the elbow. Elbow braces are available in drugstores or online. 

Peroneal tendonitis exercises 

A physical therapist can teach you how to do exercise that will increase strength and flexibility in your foot if you have peroneal tendonitis. A few include:

Calf wall stretch. Place both hands on a wall and step back with your affected leg. Keeping that leg straight, bend the front knee, shift your weight forward, and hold the stretch for 30 seconds or longer. Repeat three times.

Resisted ankle eversion. Tie a resistance band around your affected foot, then sit on a yoga mat or rug. Extend your legs straight out. While holding the end of the resistance band, press the sole of your other foot against the band (this keeps it steady). Now, turn your affected foot outward, pulling against the band, hold 5 seconds, and return to the starting position. Repeat 10 times.

Ankle inversion and eversion. Sit in a chair and cross your affected leg over the other knee. While holding the bottom of your foot, slowly tilt its sole toward the floor and hold it there for up to 10 seconds. Now pull it toward you and aim it at the ceiling, holding for up to 10 seconds. Repeat 10 times.

Elbow tendonitis exercises

Stretching and strengthening muscles that support an elbow with tendonitis is essential, experts say. To learn proper technique, work with a physical therapist. A few good exercises include:

Extension stretch. Hold your arm out straight with your palm out as if making the “halt” gesture. With your opposite hand, apply pressure to the palm and pull it toward you. You should feel a stretch on the inside of your forearm, which you should hold for 15 seconds. Repeat five times, then switch arms.

Flexion stretch. This exercise is similar to the wrist extension stretch, only you begin with the palm and fingers of your extended arm facing down.

Strengthening extension. Bend your elbow to 90 degrees and rest it on a table, aligning your wrist with the edge. Holding a very light barbell (1 to 3 pounds) with palm facing down, bend your wrist up as far as possible and hold up for one count, then slowly lower the weight. Try to do this until you can perform 30 repetitions. Over time, you can increase weight and repetitions.

Strengthening flexion. Similar to strengthening extension, only your palm is facing up.

Wrist tendonitis exercises 

If you have wrist tendonitis, a physical therapist can teach you exercises to do at home that will help you recover. A few include: 

Hand flips. Sit in a chair and place your forearm and affected wrist on your thigh with the palm facing down. Flip your hand so the back of your hand rests on your thigh and your palm is up. Repeat 10 times. 

Wrist flexion and extension. Lay your forearm on a table with your hand and affected wrist over the edge, palm down. Bend your wrist and form a fist. Hold for a count of five, then lower your hand and let your fingers relax for an equal count. Repeat 10 times. 

Wrist radial and ulnar deviation. Hold out your arm with the affected wrist in front of you with the palm facing down. Bend your wrist from side to side as far as you can, holding each position for about 5 seconds. Repeat 10 times.

 

Tendonitis often goes away after a few weeks, but if symptoms continue, you may develop complications, including: 

  • Chronic tendonitis. You could develop persistent pain when you move the muscle connected to the affected tendon. 

  • Loss of strength and limited range of motion. Along with pain, you may find that the muscle associated with the damaged tendon feels weak and won’t move easily. 

  • Tendon tears. This common complication of tendonitis may require surgery.  

Taking some simple steps can lower your risk for tendonitis. 

Warm up and cool down. When you exercise or do any type of physical activity (such as gardening), stretch and move about a bit before and afterward. As a general rule, a good warm-up is 5 minutes for every 30 minutes of planned exercise. Ease into your workout and gradually build intensity. A sudden and dramatic increase in exercise intensity can set you up for tendon strain.  

Be kind to your body. During long bouts of physical activity, take breaks often. Stop what you’re doing if you develop pain.

Vary your routine. When possible, avoid repeated use of the same joint. Don’t do just one type of exercise, such as running every day. Mix in other aerobic activities, such as swimming or cycling.

Use the right gear. Wear appropriate footwear and replace shoes when they’re worn out. 

Move right. Be sure you are using the proper technique in the activities you choose for exercise and leisure. Taking a lesson from a pro is a good idea.

Assess your workspace. You might think that sitting at a computer all day can’t hurt you, but if your keyboard or screen are at the wrong height and angle, you could be straining tendons. A physical therapist can advise you on how to set up an ergonomically friendly workspace and make sure your job doesn’t cause or worsen tendonitis.  

 

Tendonitis is a common and painful condition that can interfere with your ability to work or keep you from doing things you enjoy. Most cases respond well to milder treatments, but doctors and physical therapists can recommend strategies for treating persistent tendonitis. Learning healthier ways to move, strengthening muscles, and stretching can reduce your risk. 

How long does tendonitis take to heal? Every case of tendonitis is different, but most people notice that their symptoms are better after about 2 or 3 weeks. More serious cases can take several months. 

Does tendonitis hurt all the time? Pain is the most common symptom of tendonitis, though it’s often worse when you move the muscle connected to the affected tendon. 

What can trigger tendonitis? The most common cause of tendonitis is overuse of a joint, which can happen through repetitive motions such as a tennis swing or painting. But straining or injuring a tendon can cause tendonitis, too. 

Should I massage for tendonitis? Some doctors recommend massage for easing tendonitis symptoms, though it’s best to wait until at least two days after the original injury or when swelling and inflammation have gone away.  

Does stretching help tendonitis? Stretching is an important part of preventing and treating tendonitis. A physical therapist can show you how to perform the right stretches to protect your tendons and ease your symptoms.