If you’ve developed tendon pain after returning to the gym, increasing your running, or tackling a weekend DIY project, you’ve probably assumed it’s tendonitis.
In reality, persistent tendon pain is far more likely to be tendinopathy. Although the terms are often used interchangeably, they describe different conditions, and understanding the difference can help guide the most effective treatment.
My name is Kevin, a physiotherapist with a special interest in musculoskeletal injuries (and a soft spot for stubborn tendons).
Tendon problems are one of the most misunderstood issues I see, so this is a topic I genuinely enjoy unpacking.
While both conditions affect tendons, they are not the same.
Tendonitis refers to short-term inflammation of a tendon. It typically develops after a sudden increase in activity or an acute overload.
Examples include:
True tendonitis is relatively uncommon and often settles within a short period when managed appropriately.
Tendinopathy is the term used for persistent tendon pain and reduced tendon capacity.
Rather than ongoing inflammation, the tendon has become less able to tolerate the loads being placed upon it. This often develops gradually over weeks or months.
Research suggests that most tendon pain lasting longer than a few weeks is tendinopathy rather than tendonitis.
Many people continue treating tendinopathy as though it were tendonitis.
This often involves:
While rest may temporarily reduce discomfort, it does not improve the tendon’s ability to handle everyday activities or sport.
As soon as activity resumes, the pain often returns because the tendon has not regained its capacity.
Tendinopathy usually develops when the demands placed on a tendon exceed what it is prepared to tolerate.
Common contributing factors include:
This doesn’t mean the tendon is permanently damaged. It means it needs the right rehabilitation program to gradually improve its tolerance.
One of the most effective treatments for tendinopathy is progressive loading.
Rather than avoiding movement altogether, rehabilitation aims to gradually expose the tendon to appropriate levels of load so it becomes stronger over time.
A physiotherapy program may include:
This approach helps improve tendon capacity and reduces the likelihood of recurring symptoms.
If your tendon pain has lasted more than a few weeks, keeps returning, or is preventing you from enjoying work, exercise or sport, it’s worth having it assessed.
Early management can help identify the underlying cause and ensure you’re following the most appropriate rehabilitation plan.
Persistent tendon pain doesn’t always need more rest. In many cases, it needs the right amount of movement and strengthening.
Book a session with one of our physiotherapists to determine whether your symptoms are due to tendinopathy and receive a personalised rehabilitation program designed to help you return to the activities you enjoy.
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Written By:
Bachelor of Physiotherapy |
References
Bass, LMT, E. (2012) ‘Tendinopathy: Why the difference between tendinitis and tendinosis matters’, International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, 5(1). doi:10.3822/ijtmb.v5i1.153.
Canosa-Carro, L. et al. (2022) ‘Current understanding of the diagnosis and management of the tendinopathy: An update from the lab to the clinical practice’, Disease-a-Month, 68(10), p. 101314. doi:10.1016/j.disamonth.2021.101314.
Federer, A.E. et al. (2017) ‘Tendonitis and tendinopathy’, Foot and Ankle Clinics, 22(4), pp. 665–676. doi:10.1016/j.fcl.2017.07.002.
