• Tendons are bands of strong connective tissue that attach muscle to bone.
  • The symptoms of tendinopathy include pain, swelling and reduced function. 
  • Tendinopathy commonly affects the shoulder, wrist, knee, shin and heel.
  • Tendinopathy usually heals on its own.

About tendinopathy

Tendons are bands of strong connective tissue that attach muscle to bone.

Tendinopathy symptoms include pain, swelling and reduced function. Tendinopathy is usually a type of overuse injury, where the tendon is repeatedly strained until tiny tears form. It commonly affects the shoulder, wrist, knee, shin and heel. Most cases of tendinopathy will settle naturally. The symptoms of tendinopathy can be similar to other conditions, such as arthritis or infection, so it’s important to seek medical advice if your symptoms don't improve after a week or two of self-care.

Symptoms of tendinopathy

The symptoms of tendinopathy can include:

  • pain
  • swelling
  • stiffness and restricted mobility at the affected joint
  • muscle weakness
  • the skin over the affected area may feel warm to the touch.

Causes of tendinopathy

Some of the common causes of tendinopathy can include:

  • overuse of the tendons by repetitive actions
  • calcium deposit along the tendon at the site of insertion (where it attaches to the bone)
  • bone spurs on the heels
  • any sporting activity that requires lots of jumping and running
  • running on hard surfaces
  • poor sporting technique, such as holding a tennis racquet or golf club incorrectly
  • inappropriate sporting equipment, such as a tennis racquet that's too heavy
  • lifting weights that are too heavy
  • lifting heavy weights without warming up properly
  • neglecting to warm up properly before doing sport or exercise
  • extreme and regular physical effort, such as an intensive sports training schedule
  • not taking enough time between training sessions to allow full recovery
  • exercising in cold temperatures
  • awkward positions that are maintained for a long time
  • being obese, which puts excessive pressure on the tendons of the legs.

Self-care suggestions for tendinopathy

Ways to manage mild cases of tendonitis at home include:

  • Stop whatever activity triggered the pain.
  • Rest the area – trying to ‘work through’ the pain will only make your symptoms worse and delay healing.
  • As symptoms lessen, use the area as normally as possible – total immobilisation or rest can make the problem worse.
  • Regularly apply ice packs to the affected area, as needed, in the first few days to help reduce swelling and pain.

When to seek medical advice for tendinopathy

If your tendinopathy is severe or persistent, see your doctor. You may need professional medical care that includes prescription medication, or your symptoms may be caused by a condition other than tendinopathy. For example, you may be suffering from arthritis, bursitis, infection or a fracture.

If your symptoms haven't improved after one or two weeks of home treatment, or if the pain is severe or debilitating, see your doctor. Most cases of tendinopathy recover completely without the need for any medical input. However, uncommonly, severe untreated tendinopathy can lead to rupture of the tendon.

Diagnosis of tendinopathy

Your doctor may use a variety of tests to diagnose tendinopathy, including:

  • medical history
  • physical examination
  • imaging techniques such as x-rays, ultrasound or MRI.

Treatment for tendinopathy

Treatment options for tendinopathy may include:

  • stretching and strengthening exercises
  • weight loss advice, if necessary
  • unloading tendon with, for example, bracing
  • corticosteroid injections if there is associated inflammation
  • in persistent cases despite appropriate rehabilitation, surgery may be discussed as an option.

Reducing your risk of tendinopathy

To reduce your risk of tendinopathy:

  • Lose excess body fat, if necessary.
  • Make sure to thoroughly warm up and cool down before and after exercising.
  •  Include slow, sustained stretches in your exercise routine.
  • Make sure you maintain good form when participating in your chosen sport or exercise and resist the urge to push yourself too far too fast.
  • Reduce the risk of overtraining by participating in a range of exercises and sports.
  • Wear footwear appropriate to your sport.
  • Strain on tendons caused by bowed legs or flat feet (for example) can be eased with the use of professionally fitted shoe inserts (orthoses) – see your podiatrist for further information and advice.
  • Rearrange your workstation or daily work schedule to avoid long periods of the same manual activity (such as typing on a keyboard or using a hammer).

Where to get help

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This page has been produced in consultation with and approved by: Australian Rheumatology Association (Vic Branch)

Last updated: July 2020

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