Why You Probably Don’t Have Tendonitis (but You Can Treat Your Pain)

Most of us have heard the term tendonitis when we usually refer to conditions such as tennis elbow, swimmer’s shoulder, or any other overuse injury we may develop. When we are injured through overuse, our instinct for recovery is usually rest and ice. However, as we are now discovering, strength training is actually the best treatment. This is because much of what we usually call tendinitis is more accurately described as tendinopathy . The difference isn’t just semantics; it is also a question of which treatments will be most effective.

Over the past 10-15 years, there has been a paradigm shift in what we know about the cause of tendon pain and the best way to treat it. Considering how recently this shift has occurred, there is still a fair amount of confusion about terminology as well as what actually happens to your tendon.

“As a medical community, we have really shifted the scope of what we think is going on in the tendon, which has led to a change in naming conventions that is confusing to everyone,” said Jennifer Zellers, a professor at the University of Washington. in St. Louis, whose research focuses on tendons. Given how recent this shift has taken place, it is still common to see the term tendinitis used to refer to injuries associated with overexertion, but this is no longer the case.

What causes tendon pain?

True tendonitis, which is inflammation of the tendon, is less common than previously thought. In contrast, tendinopathy is a general term for tendon pain. In addition to tendonitis, this includes other causes, one of which is tendon degeneration.

When it comes to overuse injuries such as tennis elbow or swimmer’s shoulder, scientists have found in recent years that this pain occurs as a tendon begins to degenerate. When the tendon degenerates, small tears will develop on the tendon or the collagen fibers become disorganized. With the right treatment, the ability to heal is limited.

“There is no really strong inflammatory response in the tendon,” Zellers said. “What is happening is more like tendon degeneration. The spring proteins that make up the tendon become quite disorganized, along with some other changes in the composition of the tendons. But this is not incitement. “

Tendon Pain Treatment Options

The discovery that tendon pain often results from degeneration rather than inflammation has led to a change in treatment options. In the past, rest and anti-inflammatory drugs such as ibuprofen were prescribed to treat injuries caused by overexertion. While this will lessen the pain, it will not actually eliminate the cause of the problem.

“One of the most effective treatments is to gradually increase the load on the tendons,” Zellers said. “It’s more about changing someone’s activity, not total rest, and it’s much more about putting more and more stress on the tendon, but in a way that the tendon can adapt and respond and be ready for higher loads “.

This treatment is often led by a physical therapist who can advise on what exercises to do, how many reps, and with what weight. However, as Zellers notes, progressive tendon loading can be achieved without the use of special equipment. Instead, a person may only need weights.

“When someone really feels comfortable with how to manage themselves and self-development, this is something that someone should be able to handle on their own without going to a physical therapist for a long time,” Zeller said.


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