A tendon is a fibrous connective tissue that joins a muscle to a bone.  Tendons are made of collagen and are designed to withstand load and transmit force.

What’s the difference between tendinitis, tendinosis, and tendinopathy?

Tendinitis and tendinosis both fall under the umbrella of tendinopathy, or disease of tendon.  Overuse or repetitive trauma often leads to tendon pathology.

  • Tendinitis refers to an acute tendon injury that results in inflammation. The tendon is overloaded and micro-tearing occurs. This causes swelling of the injured tissue and produces localized pain, warmth, redness, and discomfort.
  • Tendinosis occurs when the tendon fails to heal and there is repetitive trauma. There is no inflammation present because of the chronic degeneration of the tendon tissue.  Because of this chronicity, the collagen loses its continuity and the fibers no longer align.  This means they can no longer cross link, resulting in weakened, injury prone tendons.

 

How long does it take for tendinopathies to heal?

  • With tendinitis, since inflammation is present the classic RICE (rest, ice, compress, elevate) protocol can be beneficial. Anti-inflammatories, cortisone injections, and physical therapy can reduce pain and swelling and potentially get you back in 4-6 weeks.
  • Tendinosis is a chronic condition, and therefore takes longer for collagen to rebuild. Often faulty mechanics and malalignments cause repetitive trauma to the tendon, which results in cellular disarray and negative structural changes within the tissue.  Since this is a much more vicious cycle, it can sometimes take up to 6 months for you to heal without risk of further injury.  Remember, the tissue’s properties have physically changed with tendinosis, so it is a much longer process to re-establish a proper collagen foundation.

 

Does Physical Therapy help with tendinopathies?

Yes!  Physical therapy is very beneficial in promoting healing and disrupting the injury cycle, especially with tendinosis.  Physical therapy focuses on stretching the tissue to maintain motion, utilizing modalities to encourage blood flow and healing, performing cross friction massage to break up scar tissue and poorly laid collagen fibers, offering bracing to decrease pain, and providing exercises to eccentrically load the tendon for correct force production as well as optimize your biomechanics to prevent re-injury.

 

Where are common sites for tendinopathies?

 

If you are unsure how physical therapy can help your tendinopathy, reach out to your Wallace & Nilan Physical Therapist for answers!