Facts about tendinopathy

You may experiment often an unusual burning pain getting worse with movement? Your flexibility and range of motion is affected, and it may appear swelling tissue, weakness and impaired function?

You are probably experiencing a tendon injury or disorder due of a chronic overused, incorrect repetitive movementor following recent trauma.

A tendon is a cord, a regular connective tissue made of collagen that connects bone and muscle. It transmits and modulates forces during locomotion providing also stability in the joint it mobilizes.

As muscles are present everywhere in our body, it’s easy to understand that this problem can occur anywhere. However, some areas are more solicited, it commonly appears around the ankle (Achilles tendinitis), the knee (patellar tendon), the wrist, the elbow (tennis or golf elbow) or shoulder (rotator cuff tendinitis, biceps tendinitis…).

We don’t yet know anything about tendinopathy, but there are fundamental facts that both doctors and patients need to know.

1 – Tendinopathy with rest does not help.

The pain can slow down but it is still painful to return to action because rest does not enable the tendon to improve its resistance to physical pressure.

2 – There is NO clear proof that the inflammation triggers tendinopathy.

There are certain inflammatory molecules involved, so anti-inflammatory drugs can play a part often but can also be dangerous.

3 – In the origin of tendinopathy, various risk factors may be involved.

The primary cause is tendon overuse or actually repetitive exercise. This involves certain behaviors that allow the tendon to conserve energy (walking, biking, jumping) and which cause tension on the tendon. There are other predisposing factors, such as biomechanical (muscular ability, etc.) or systemic factors (age, menopause, hypercholesterolemia, etc.). During very slight changes in the habits, predisposed people will experience tendon pain.

4 – Exercises are the best treatment of tendinopathy based on facts.

Tendons need to be slowly placed back under stress to build a greater tolerance to the stresses that the person needs to experience in their daily lives. Tendinopathy does not progress in most cases without this vital mechanical control stimulus.

5 – A significant factor in minimizing tendon pain is increasing the mechanical tension.

The constraints of energy storage and compression are always to be reduced (at least temporarily).

6 – Changes in imaging of pathological (degenerative) tissue are NOT associated with pain. They’re normal in painless people.

Even if you’ve been told you’ve got “serious tissue disease” in the imaging, or even a tear, it doesn’t mean you won’t get any better or your prognosis will get worse. Furthermore, we know that the dysfunctional tissue does not in the majority of situation0s improve except with the best efforts and the most advanced therapies (exercises, infiltrations, etc.). Consequently, the bulk of procedures are intended to promote pain and function rather than to improve the appearance and recovery of the tissue.

7 – Owing solely to passive treatment strategies, tendinopathy only improves very rarely in the long term. Exercises are the key component and passive therapy is simply an auxiliary element.

Such drills can never be replaced by massages, ultrasounds, penetration, shock waves. Only exercises will rehabilitate the tendon slowly to sustain the workload. Frequent infiltration needs to be avoided because then the effect is worse.

8 – You have to individualize the exercises.

They’re focused on every patient’s painful and practical presentation. In order to reach the goals of restoring the function of the patient, your therapist must offer treatment that increases stress gradually, while respecting painful responses.

9 – Tendinopathy responds to exercise very slowly.

You need to be vigilant, ensure the exercise is performed correctly and your improvement is satisfactory, and above all seek to avoid the normal temptation to resort to shortcuts such as infiltration and surgery. There aren’t so much shortcuts.


Osteopathy makes it possible to act effectively in the prevention, treatment and recovery of tendonitis. Sporty or not, everyone is concerned!

The treatment consists first of all in identifying and stopping the movement that is causing the pain. In the same time, it allows you to rebalance muscle chains, identify and treat joints under stress and other impacted structures!

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