The Joint Ventures' Blog

The Difference Between Tendonitis And Tendonosis And Why It Matters

Thursday, September 26, 2013

For many years, most tendon pain has been referred to as tendonitis (i.e. lateral epicondylitis, bicipital tendonitis, plantar fasciitis), when current studies are showing that tendonosis is much more common and a more appropriate name for many of these injuries (lateral epicondylosis, bicipital tendonosis, plantar fasciosis).

achilles tendon problems, tendonitis, lateral epicondylosis, bicipital tendonosis, plantar fasciosis


The suffix ‘itis’ in medical terminology means inflammation, therefore tendonitis literally means inflammation of a tendon.  Tendonitis is an accurate diagnosis for an acute injury when the tendon is overloaded, causing pain and swelling from tears in the injured tissue.   On the other hand, tendonosis occurs from failed healing or repetitive trauma to a tendon.  This chronic microtrauma leads to loss of collagen continuity which means the fibers are no longer aligned and fail to link together, resulting in loss of strength and further injury when used.  However, inflammation is not generally present with tendonosis.


The reason to differentiate between tendonitis and tendonosis is to utilize more appropriate treatment techniques and timelines.  Treatment for tendonitis starts with good old fashion RICE (rest, ice, compression, elevation) to reduce inflammation and allow healing.  The tendonitis should heal in about 6 weeks and will benefit from anti-inflammatory medicine, cortisone injections, and physical therapy.  When it comes to tendonosis, anti-inflammatory medicines and cortisone injections are not indicated, nor are they the best course of treatment, because they inhibit collagen repair.  Tendonosis healing time is 3-6 months once it becomes chronic.  Studies show that it takes up to 100 days to rebuild collagen.  The primary treatment plan for tendonosis is to break the injury cycle and reduce stress on the tendon with rest, proper ergonomics/biomechanics, appropriate support (bracing) and Physical Therapy.  Therapy should include light stretching to preserve motion and increase circulation, cross friction massage, eccentric strengthening and icing.

Please feel free to contact me at with further questions about this topic.

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