What is Tendinosis?

C. Ausbrooks

Tendinosis is the medical term used to describe inflamed or irritated tendons that do not heal and eventually begin to degenerate. The condition is sometimes called chronic tendon injury or chronic tendinitis. Tendons are the thick bands of fibrous tissue that connect muscle to bone, and they are typically able to withstand considerable tension. Overuse or injury of the tendons, however, may lead to inflammation or degeneration in severe cases.

A diagram of the Achilles tendon and common tendon problems, including tendinosis.
A diagram of the Achilles tendon and common tendon problems, including tendinosis.

Tendinosis usually only affects one area of the body at a time, and is more common in middle-aged individuals. The tendons become more worn and prone to inflammation with age, but the condition can affect anyone. People who regularly perform repetitive tasks such as typing are more likely to develop the disorder later in life.

Injury and overuse are the most common causes of tendinosis.
Injury and overuse are the most common causes of tendinosis.

The most common causes of tendinosis are injury or overuse. If a tendon is injured and not allowed to heal, it will begin to degenerate, resulting in pain and discomfort of the affected area. In rare cases, an infection present in the tendon sheath, or layer of membrane around the tendon, may cause the condition.

People with tendinosis may benefit from a tailored physical therapy regimen.
People with tendinosis may benefit from a tailored physical therapy regimen.

The symptoms of tendinosis are similar to those of tendinitis, which sometimes makes diagnosis difficult. Common symptoms include pain and stiffness around the area of the tendon, a burning sensation around the tendon, pain that worsens during and after activity, swelling and the accumulation of fluid around the tendon. The tendons may also cause a grating sound that a doctor can hear with a stethoscope when they rub against the tendon sheath.

An orthotic brace may be used to treat tendinosis of the ankle.
An orthotic brace may be used to treat tendinosis of the ankle.

There are numerous tendinosis treatments available, but they are general and don't dramatically speed the healing process. They can, however, be used to manage symptoms, reduce pain and begin healing the damaged tendons. Common treatments include rest, physical therapy, shockwave therapy, cold treatment, orthotics, nutritional supplements and as a last resort, surgery.

Alternating hot and cold therapy may be recommended to help reduce pain and swelling from tendinosis.
Alternating hot and cold therapy may be recommended to help reduce pain and swelling from tendinosis.

Resting and physical therapy may be the most effective treatments available for sufferers of tendinosis. Rest allows the tendon time to heal, and physical therapy can help expedite healing if the correct exercises are prescribed. Shockwave therapy is a relatively new treatment that delivers sound waves directly to the affected tendon, which is believed to reduce pain and speed healing. Cold treatment is a temporary pain relief method in which ice packs are placed on the area to reduce symptoms.

Over time, tendinosis of the wrist can cause debilitating pain and greatly reduced mobility.
Over time, tendinosis of the wrist can cause debilitating pain and greatly reduced mobility.

Orthotics are often used to treat tendinosis of the wrist, elbow, ankle and knee. Orthotic braces help support the tendons during activity, but cannot be worn at all times or strength and flexibility may be lost. Sometimes nutritional supplements are used in conjunction with other treatments. Although there is not much scientific evidence to support the claims for these supplements, many patients have reported good results from taking vitamin C, vitamin E, glucosamine and chondroitin. Surgery is performed for treating tendinosis only when the patient experiences severe, chronic pain and is unresponsive to other treatments.

Some patients report that vitamin C and other supplements can help with tendinosis.
Some patients report that vitamin C and other supplements can help with tendinosis.

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