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Tendinitis vs. Tendinosis

I have received a few questions regarding the difference between tendinitis and tendinosis lately.

Tendinitis is an outdated term used to describe a recent injury to a tendon that results in inflammation (swelling) surrounding a tendon. Research has shown that commonly, there are no inflammatory cells found in painful tendons. The term tendinosis or more generally tendinopathy can often be used instead.

Tendinosis is the term used for a chronic long term injury to tendons. Chronic tendon problems are degenerative in nature which means the tendons contain increased blood supply, abnormal structure, and fat deposits but NO INFLAMMATORY CELLS.

A better term to use is tendinopathy. This is a general all inclusive word that is less descriptive but identifies the problem as the tendon versus any other structure.

So why is any of this important?

If most tendon problems are chronic and degenerative with little to no inflammation, then why are we often using non-steroidal anti-inflammatory drugs (NSAIDs) to treat them? The pain relieving effects of these drugs are obvious but the anti-inflammatory effect (occurs after 4-5 days of high dosage) doesn’t actually treat the problem. The actual problem is a weakened tendon from frequent mild strain where the tendon doesn’t have the time or nutrition to heal itself. The final strain the patient complains about was just an accident waiting to happen. Therefore treatment should be aimed at creating new collagen at the injury site. The most non-invasive methods to stimulating collagen growth is through nutrition, eccentric exercise, and deep massage techniques.

Deep massage techniques such as deep friction massage, instrument assisted soft tissue mobilization, and Active Release Technique all have the ability to initiate new collagen formation. Quality nutrition and a focused exercise program will further support the creation of additional collagen to rebuild the damaged tissue. This approach helps in most cases so a surgical consultation is rarely needed.

I’d love to help you feel better.