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What is Tendonosis?

By D. Jeffress
Updated May 17, 2024
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Tendonosis is a common cause of tenderness, chronic pain, and weakness in body tendons. The condition is characterized by damage to the inner layers of a tendon on the cellular level. Unlike tendinitis, which affects a large section of tissue and induces inflammation, tendonosis is not a true inflammatory disorder. Symptoms result from the body's inability to heal microscopic damage and replace dead cells. There are no proven medical treatments for tendonosis, and most people need a combination of physical therapy and surgery to fully overcome the problem.

It is not always clear what triggers tendonosis, but doctors believe that cell degradation typically results from an inadequate supply of blood and nutrients to the cells. Athletes and people who engage in intense physical activity are at risk of putting too much strain on their muscles and tendons, which can make them tight and less able to absorb blood. Aging is another prominent risk factor, as bones, tendons, and muscles tend to weaken over time. In addition, an acute or chronic injury can result in inflammation and scarring that prevents a tendon from receiving enough blood.

The most common sites for the condition are the rotator cuffs in the shoulders and the Achilles tendons in the ankles. Baseball pitchers, quarterbacks, and other athletes who use their arms repetitively are at the highest risk of rotator cuff tendonosis. Achilles tendon injuries are common in runners and athletes who are required to frequently jump, stop, and turn. The disorder can also arise in finger and wrist tendons in people who type, write, or draw for several hours a day. Other possible sites include the knees, elbows, feet, or the lower back.

Symptoms may not be noticeable until extensive damage has occurred. The most common symptoms are tenderness, aches, and tightness in the affected body part. An injury can also cause weakness and occasional burning or tingling sensations. If the condition goes untreated, degrading tissue may suddenly tear apart and cause immediate, debilitating pain.

A doctor can check for tendon problems by performing a physical evaluation and taking diagnostic imaging scans. Ultrasounds, x-rays, and magnetic resonance imaging scans can usually reveal cell-level damage to a tendon. Relatively minor or early-stage tendonosis can sometimes be relieved with rest, ice, and taking painkillers for about two to four weeks. If problems become serious, surgery may be necessary to repair or replace a tendon. With follow-up physical therapy and limited activity for several months, injuries generally heal well.

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Discussion Comments
By irontoenail — On Apr 03, 2013

If you have a look at all the different tendonosis treatments that people are currently trialing, there are some really interesting looking ones.

There is one trial where they are basically growing whole new tendons using cells layered on a bundle of silk threads. And another where the tendons are encouraged to renew themselves with shock-wave therapy.

By KoiwiGal — On Apr 02, 2013

@croydon - Well, I've heard that it is often associated with periods of stress in a person's life, so it's definitely not just athletes who get it.

My mother had chronic tendonosis in her shoulder, which led to quite severe pain whenever she moved it the wrong way or jarred it. It's not a pleasant condition to have, at all.

I suspect it was also partly because she had diabetes, but I'm not sure if there's a documented connection there. It would make sense though, since many of the long term symptoms of diabetes (like gangrene and loss of eyesight) happen because of degradation of the small blood vessels and that would also lead to cell degradation, which is supposed to be what causes tendonosis.

By croydon — On Apr 01, 2013

I've had tendinitis before, but I've never had tendonosis. I get tendinitis when I let my feet get cold and don't do anything to warm them up or move them around. I don't know why, but that seems to set on tendinitis in my Achilles tendon. A few anti-inflammatory pills and a bit of rest usually clears it up though.

It sounds like tendonosis is mostly confined to athletes or other people who put extreme stress on their bodies, so I guess I don't really have to worry about it too much.

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