Tendonitis or Tendinosis?

A tendon is the structure that connects a muscle to a bone. Endurance athletes are predisposed to tendon injuries due to the prolonged stress that they put on there bodies. Often athletes with tendon injuries are diagnosed with “tendonitis”. The “itis” suffix means inflammation. For example, if someone is diagnosed with Achilles tendonitis this would mean that there is inflammation in there Achilles tendon. However, in the past few years scientific research has shown that tendonitis is rarely present in chronic injuries because there is a lack of inflammatory cells. Inflammation will be present in some cases, if it’s new injury for example. But if your tendon has been painful for a while and not getting better the proper diagnosis might be tendinosis. The suffix “osis” means; affected with, condition or abnormal process. In a tendinosis the tendon is affected with a degenerative process or a build up of scar tissues.

In my practice I rarely find tendonitis problem in endurance athlete but more often tendinosis. The importance of a specific diagnosis in this case will change your treatment. If you are diagnosed with tendonitis, the treatment will usually be geared towards reducing the inflammation. So you will use ice, you might even use anti-inflammatory medications. If you have a tendinosis the treatment will be completely different. The treatment plan will be geared towards breaking down the scar tissue. In my practice I use Graston technique and myofascial release techniques to break down that scar tissue. Eccentric loading exercises have also been shown to be effective in treating tendinosis. It is important to get a proper diagnosis and not try to treat yourself because there is a risk of getting worse or even tendon rupture.

To summarize, tendonitis is rarely seen in endurance athlete, tendinosis is more often found. Proper diagnosis will lead to proper treatment and help you get back to your sport faster and pain free.