Tendonitis / Tendinosis

The most common pathological problem involving tendons used to be referred to as tendinitis but is now more correctly known as tendinosis, which means abnormal condition of the tendon. Tendinitis implies an inflammatory condition and it was previously believed that chronic overuse lead to tendon fiber tearing and inflammation. True tendinitis, which is tendon fiber tearing with inflammation, does occur but it is a rare condition.

Because of the lack of inflammatory activity in these conditions, the term tendinosis is encouraged. The term tendinosis does not specify the pathological process, only that the tendon is dysfunctional. High levels or prolonged periods of tensile stress on the tendon can lead to collagen breakdown. While any tendon can develop tendinosis, tendons in the arms and legs (extremities) are more susceptible. Another result of chronic load on the tendon is alteration in the tendon’s blood flow (vascularity).

Even though there is significant research and evidence showing that it is the pathology of tendinosis occurring, physician diagnosis and rehabilitation practitioners often call this injury tendinitis. Rehabilitation in many cases continues to focus on anti‐inflammatory treatment strategies, rather than collagen rebuilding. In some cases use of anti-inflammatory medication can be detrimental for healing collagen degeneration. Overuse tendon disorders can take a long time to heal due to the slow rebuilding of collagen. Collagen rebuilding is a slow process and tendinosis can become chronic or recurrent.

Another chronic overuse tendon problem is tenosynovitis, which is an inflammation and/or irritation between a tendon and its surrounding synovial sheath. This condition affects only those tendons enclosed within a synovial sheath. The synovial sheath surrounds tendons in the distal extremities and a few other locations, such as the biceps brachii long head tendon as it travels through the bicipital groove in the shoulder. The sheath reduces friction between the tendon and the retinaculum (or, infrequently, a ligament) that binds the tendon close to the joint. The tendon must be able to glide freely within the sheath.

Chronic overloading or excess friction leads to adhesion between the tendon and its sheath. The adhesions cause a roughening of the surface between the tendon and its sheath and a subsequent inflammatory reaction results. The rough tendon surface routinely produces crepitus (grating sensations) when the muscle‐tendon unit and affected joint are moved through their range of motion.

If you have any of these problems or anything that seems close to these symptoms it’s a good chance that the muscles all around the area are brutally tight. It’s no mystery why you have pain: You can’t get into certain positions or move with good form because you’re missing key ranges of motion. Mitigating these “overtensioned” muscles and systems using soft tissue manipulation techniques allows the areas to loosen and creates slack to the injured site(s). This is the key to long term relief.

As Bodyworkers & Functional Movement Therapists we focus on balancing the muscle and fascial systems of the body to improve range of motion, posture, and support pain free living. We are able to view your muscle imbalances and Design the best treatment plan specific to your needs and properly address your tendonitis issues