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(Tendonitis; Tendinosis)
  • Definition

    Tendons connect muscle to bone and help move joints. Tendinopathy is an injury to the tendon. These injuries tend to occur in tendons near joints such as the knee, shoulder, and ankle. The injuries can include:
    • Tendonitis—An inflammation of the tendon. Although this term is used often, most cases of tendinopathy are not associated with significant inflammation.
    • Tendinosis—Microtears in the tendon tissue with no significant inflammation
    The following tendons are often involved:
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  • Causes

    Tendinopathy is caused by overuse of a muscle-tendon unit. The strain on the tendon causes tiny tears that build up over time. There can also be inflammation.
    These tears cause pain and can eventually change the structure of the tendon.
  • Risk Factors

    Tendinopathy is more common in women than in men. It is also more common in older adults. Factors that may increase your chance of getting tendinopathy include:
    • Overuse can be the result of doing any activity too much
    • Strenuous or repetitive activities:
      • Sports
      • Physical labor
      • Housework
    • Physical problems
      • Muscle imbalance
      • Decreased flexibility
      • Overweight
      • Alignment abnormalities of the leg
  • Symptoms

    Symptoms may include:
    • Pain in the tenon or surrounding area, particularly with activity
    • Decreased motion of related joints
    • Local swelling
    • Weakness
  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.
    Images may be taken of the tendon and bone. This can be done with:
  • Treatment

    Treatment depends on:
    • Severity of symptoms
    • The tendon involved
    • Length of time symptoms have lasted
    Talk with your doctor about the best treatment plan for you. Options may include:
    Supportive Care
    The tendon will need time to heal. Supportive care may include:
    • Restricting activities. Normal activities will be reintroduced gradually.
    • Ice therapy to help relieve swelling
    • A cast, splint, or counterforce brace to support the tendon
    • Shoe inserts or orthotics
    Prescription or over-the-counter medication may be advised to reduce pain. Cortisone injections may be used if other treatments do not alleviate pain.
    Physical Therapy
    A physical therapist will assess the tendon. An exercise program will be created to help recovery and to strengthen the muscles.
  • Prevention

    To prevent tendinopathy:
    • Gradually work yourself into shape for a new activity.
    • Gradually increase the length of time and intensity of activities.
    • If you have a tendon that has been a problem, gradually stretch out that muscle/tendon unit.
    • Strengthen the muscle to which the tendon is attached.
    • If you have pain, do not ignore it. Early treatment can prevent the problem from becoming serious.
    • Learn to back off from activities if you are tired or not used to the activity.
    • Warm-up the affected area before activity.

    American College of Sports Medicine

    FamilyDoctor—American Academy of Family Physicians


    Canadian Orthopaedic Association

    Canadian Orthopaedic Foundation


    Exercise-induced leg pain. American College of Sports Medicine website. Available at: Accessed February 12, 2016.

    Mayor RB. Treatment of athletic tendinopathy. Conn Med. 2012;76(8):471-475.

    Patellar tendinopathy. EBSCO DynaMed website. Available at: Updated December 22, 2015. Accessed February 12, 2016.

    Patellar tendon tear. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: Updated August 2009. Accessed February 12, 2016.

    10/26/2010 DynaMed's Systematic Literature Surveillance. Massey T, Derry S, et al. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

    4/24/2014 DynaMed's Systematic Literature Surveillance Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: Updated 2013. Accessed March 9, 2015.

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