Tendonopathy, Tendonitis and Tendonosis

Tendonopathy, Tendonitis, Tendonosis.  Three frequently used buzz words in the sports medicine community, but what do they all mean, and how do they affect your care in Physical Therapy?  This post will define these three terms, and address what they mean when they come to healing and returning to your sport of choice.

Definitions:

Tendon: A connective tissue that connects muscle and bone.  The most common tendon issues come in the shoulder  - also known as “throwers shoulder” ; the knee  - commonly known as “jumpers knee” ; the elbow – known as tennis and golfers elbow; and the ankle – known as Achilles tendonitis.  It is important to note, however, that tendons exist throughout our bodies and these injuries can happen to any of them.

Tendonopathy is an umbrella term to cover any problem with a tendon of the body.

Tendonitis – is the first onset of pain in a tendon.  It is often noted to be swollen, painful with, and without activity and  painful to touch.  This typically lasts 3-7 days.  

Tendonosis – is a more long standing issue with the tendon.  This can follow a tendonitis condition and is often related to pain at the start of activity, and after activity is completed.  It is important to note that after the tendon is “warmed up” the pain may often go away.

Initial treatment for both tendonitis and tendonosis should follow the RICE principle:

R – Rest – This rarely means complete stopping of you activity, but it is important to note that your tendon is not able to withstand the workload you have been placing on it, and that is why it is injured.  We need to rest the painful area relative to the workload that injured it in the first place.  In the case of a runner, for instance, decreasing mileage for a period of 1-2 weeks may be sufficient.

I – Ice – The injured body part will benefit from the anti-inflammatory and the pain relief benefits of ice.  Typically, 10-15 minutes of ice several times a day is sufficient.

C- Compression – when convenient, gentle compression with an ace bandage or supportive elastic brace will provide pain relief for the injured tendon.

E – Elevation – combined with ice, elevation will provide relief of any swelling or fluid that may build up in the injured area, particularly if it is the knee or the ankle that is sore.  

If the initial 1-2 weeks of self-treatment with these recommendations is not successful, it is recommended that you contact a health care provider, as your injury may be significant enough to require additional treatment, therapy, or exercise prescription.