Tendinitis vs. Tendinosis

There is a common misconception regarding the term we commonly hear called "tendinitis" and a term we don't hear as often called"tendinosis". However, the latter is far more common than most of us think.

Tendinitis is an inflammation of the tendon. Tendinosis is degeneration within the tendon caused by repetitive microtrauma, decreased blood supply to the tendon, or the natural aging process.

When a tendon is repetitively stressed or "overused" microtears form on the tendon in turn igniting an inflammatory process, which is called tendinitis. The inflammation can usually last anywhere from 7-10 days. It can be decreased if treated promptly with rest and anti-inflammatory agents such as ice and anti-inflammatory medications (NSAIDS, OTC Ibuprophen such as Advil, Motrin, etc.).

However, if the tendon is continuously placed under stress for an extended period of time the condition can no longer be called tendinitis and is now termed tendinosis. The reason for the name change of the condition is due to the physiological changes of the tendon. Due to increased stress, the tendon becomes ischemic meaning there is decreased blood supply to the tendon. If the tendon is ischemic for an extended period of time the collagen (that all tendons are made up of) begins to die. Once the collagen dies there is no longer a presence of inflammatory cells. If there are no inflammatory cells that means there can be no inflammation (aka tendinITIS) and therefore, NO PAIN. I am sure no pain sounds great to all of you, but this is very bad. If there is a lack of pain there is no way for your body to tell you if and when the tendon has been overly stressed again. Hence, there is a very high chance that the tendon will rupture or tear completely as in when an individual tears their Achilles' tendon.

Collagen can regenerate if the proper treatment is rendered. If the tendinitis has become tendinosis it is much harder and it takes longer, but it can still be done. So if you think you have tendinitis, please do not wait for the pain to go away because with the proper treatment it will not turn into tendinosis. It doesn't hurt to get it checked out, right?