Tendinitis (Tendinopathy)

What is Tendinitis?

Tendinitis, also called tendinopathy (disease of tendon), refers to inflammation or degeneration (tendinosis) of a tendon—the thick, fibrous tissue connecting muscles to bones. It often results from repetitive strain, overuse, injury, or ageing.

General Symptoms of Tendinopathy

  • Pain and tenderness, particularly with activity

  • Stiffness and reduced movement in the affected area

  • Swelling or thickening of the tendon

  • Decrease function in the area due to pain and weakness

Tendinopathy

Common Areas Affected By Tendinopathy

Bicipital Tendinopathy (Shoulder)

  • Pain at the front of the shoulder, particularly with overhead activities or lifting

  • Often associated with repetitive lifting, throwing, or other overhead motions

Flexor and Extensor Tendinopathy (Elbow)

  • Pain either on the inner side (flexor tendinopathy, golfer’s elbow) or outer side (extensor tendinopathy, tennis elbow)

  • Typically caused by repetitive gripping, wrist movements, or elbow strain

Achilles Tendinopathy (Heel)

  • Pain at the back of the heel, especially noticeable during walking or running

  • Common in runners or individuals engaging in repetitive jumping or prolonged standing

Patellar Tendinopathy (Knee)

  • Pain just below the kneecap, often exacerbated by jumping, squatting, or stair climbing

  • Frequently occurs in athletes involved in sports with repetitive jumping or knee loading

Biceps Tendinopathy
Extensor Tendinitis
Achilles Tendinopathy
Patellar Tendinopathy
Shoulder Assessment

Assessing Tendinopathies

Clinical assessment typically involves:

  • Thorough patient history to understand activity patterns and symptom development

  • Physical examination focusing on tenderness, swelling, and joint mobility

  • Imaging (such as ultrasound or MRI), if required, to confirm diagnosis and rule out other conditions

Typical Prognosis

With appropriate conservative treatment, most tendinopathies improve significantly over several weeks to months. Chronic or recurrent cases may require ongoing management and lifestyle modifications.

Evidence-Based Management

Clinical guidelines recommend:

  • Exercise Therapy: Specific strengthening and stretching exercises to improve tendon strength and flexibility.

  • Activity Modification: Adjusting or temporarily avoiding aggravating activities.

  • Manual Therapy: Techniques such as soft tissue mobilisation, joint mobilisations, and muscle release to improve function.

  • Pain Management: Short-term use of analgesics or anti-inflammatory medications, according to clinical guidelines.

  • Supportive Measures: Bracing, taping, or orthotic devices to support and reduce tendon strain.

  • Advanced Treatments: Shockwave therapy or injections for persistent cases, following clinical recommendations.

Managing Tendinitis