Tendonitis vs. Tendinosis: Decoding the Differences in Tendon Health

 Tendon health is a critical component of our musculoskeletal system, and when issues arise, understanding the nuances between tendonitis and tendinosis is essential. In this blog, we’ll delve into the key distinctions between these two conditions, shedding light on their causes, symptoms, and appropriate treatment approaches. We will be decoding the differences in tendon health.

Defining Tendonitis and Tendinosis:


Tendonitis refers to the inflammation of a tendon, which is the thick fibrous tissue that connects muscle to bone. In cases of tendonitis, the affected tendon becomes irritated or inflamed due to repetitive stress, overuse, or sudden injury. This condition is often characterized by pain, swelling, and tenderness in the affected area.


Tendinosis, on the other hand, is a degenerative condition that involves microscopic tears and the breakdown of collagen fibers within the tendon. Unlike tendonitis, tendinosis is not primarily driven by inflammation. Instead, it reflects a chronic, long-term issue resulting from ongoing wear and tear, aging, or insufficient healing. Tendinosis tends to develop over time and is associated with the breakdown of collagen in the tendon.

Key Differences:


Tendonitis: Inflammation is a hallmark of tendonitis. The affected tendon experiences redness, swelling, and heat due to the inflammatory response. This is often a result of acute injuries, sudden strain, or repetitive stress irritating.

Tendinosis: Inflammation is not a prominent feature in tendinosis. Instead, the focus is on degenerative changes within the tendon, involving microscopic damage and collagen breakdown without the overt signs of inflammation. 

Onset and Duration:

Tendonitis: Typically has a more sudden onset and may develop after a specific incident or over a short period of intense activity. It can be acute and resolved with appropriate rest and treatment.

Tendinosis: Develops gradually over time and is considered a chronic condition. It often reflects long-term wear and tear on the tendon, with symptoms persisting and potentially worsening if left untreated.

Pain Characteristics:

Tendonitis: Pain is often more acute, with a throbbing or sharp sensation. The pain is typically more noticeable during and immediately after activity.

Tendinosis: Pain may be more chronic and persistent, with a dull ache or stiffness. It can be present during activity and at rest, indicating ongoing degenerative changes within the tendon.

Diagnostic Imaging:

Tendonitis: Imaging studies may show signs of inflammation, such as increased blood flow or swelling in the affected area. Ultrasound or MRI can be used for diagnosis.

Tendinosis: Imaging studies may reveal structural changes within the tendon, such as thickening, irregularities, or areas of degeneration. MRI is often employed to assess the extent of tendinosis. 

Treatment Approaches:


Rest and activity modification.

Ice and anti-inflammatory medications.

Physical therapy for stretching and strengthening exercises.

Supportive measures such as braces or taping.


Gradual return to activity with modification.

Eccentric strengthening exercises to promote tendon healing.

Modalities like ultrasound or shockwave therapy.

Platelet-rich plasma (PRP) injections in some cases.


Understanding the differences between tendonitis and tendinosis is crucial for accurate diagnosis and effective treatment. Whether it’s inflammation-driven tendonitis or the chronic degeneration seen in tendinosis, early intervention, appropriate rest, and targeted rehabilitation are key to restoring optimal tendon health. If you’re experiencing persistent pain or discomfort, consulting with a healthcare professional, such as a physical therapist, can guide you toward a tailored treatment plan based on the specific nature of your condition. Let us help you get back to enjoying more FREEDOM, schedule your appointment today.

Rachel graduated with honors from Concordia University Wisconsin in 2014 with a Bachelor of Science in Exercise Physiology and in 2017 with her Doctorate in Physical Therapy. At Concordia, Rachel had the opportunity to take advanced coursework in manual therapy and sport specific training.