Tendinopathy vs. Tendonitis

Tendinopathy vs. Tendonitis

TENDINOPATHY – What is it and why does it matter?

Many people nod their head when they hear the word tendonitis in reference to a tendon injury, but look confused when the term “tendinopathy” or “tendinosis” is used.

Quick recap:

Tendinopathy = an overuse tendon injury

Tendinosis = describes the pathology of tendinopathy -  i.e. a degenerative process.

Tendonitis = an inflammatory condition of the tendon

The role of the tendon is to store and release energy. It connects muscles to bones. What we now know is that most tendon cells lack inflammatory cells where they bear load. The process of a tendinopathy non-inflammatory in nature.

Hence a true “Tendonitis” is actually quite rare.

A tendinosis, or tendinopathy is a reactive and degenerative process in response to improper loading. For runners facing tendon issues – this is your problem.

Every time you load your tendon (through exercise) it goes through a repair and remodeling phase where new collagen is synthesized. Tendinopathy occurs when the rate of loading exceeds the rate of repair.

Tendinopathies fall on a continuum. If you do a little too much – the tendon becomes reactive. If you address how you’re loading it, it should settle quite quickly.

However if you’ve been overloading your tendon for some times, or as you get older – the tendon may become weaker. This can take longer to resolve.  

The good news is tendons respond well to structured and progressive strength training. Most of these protocols last for 12 weeks.

If we can now understand that a Tendinopathy is a degenerative rather than an inflammatory response we can then understand that rest is not best when it comes to managing a tendon injury. So let’s abandon the term “tendonitis” – as it’s not relevant and quite outdated!