What is tendinopathy?

Tendinopathy is a painful condition that affects your tendons. Tendons are a type of body tissue that connect muscles to bones.

Tendinopathy is an overuse injury. It's different to a muscle strain or ligament sprain.

There are 2 main types of tendinopathies:

• tendinitis — inflammation of the tendon
• tendinosis — degeneration (breakdown) of the tendon

Common places where tendinopathy can occur are in the:

• knees — this is known as patellar tendinopathy
• elbows — this is sometimes called epicondylar tendinopathy, 'tennis elbow' or 'golfer's elbow'
• buttocks — this is known as gluteal tendinopathy
• shoulders — such as tendinopathy that affects the rotator cuff
• ankles — such as tendinopathy that affects the Achilles tendon

What are the symptoms of tendinopathy?

Tendinopathy can cause:

• pain and swelling
• aching
• weakness
• difficulty moving the affected area

What causes tendinopathy?

Tendinopathy happens when a tendon is injured or strained. This can be caused by doing the same movements over and over again. It can also be caused by sudden movements that put too much stress on the tendon.

You may be more at risk of tendinopathy if you:

• are physically active or play sport
• exercise with footwear that is not suitable
• increase the intensity of your exercise over a short period of time

When should I see my doctor?

See a doctor if:

• your pain persists or worsens
• your pain interferes with your daily activities, work or sports
• you have swelling, redness or heat around the affected area
• the affected joint is difficult to move
• you notice a change to your skin colour in the affected area (for example, if the skin turns blue or white)
• you develop fever-like symptoms

Your doctor can diagnose the condition, provide appropriate treatment and give you advice on how to manage and prevent further problems. Your doctor may also refer you to a physiotherapist or occupational therapist.

Don't ignore the symptoms of tendinopathy, as early treatment can lead to faster recovery and better outcomes.

How is tendinopathy diagnosed?

Your doctor can diagnose tendinopathy by:

• examining you
• asking you about your symptoms and pain
• referring you for other tests to rule out other causes — such as an MRI scan, ultrasound or x-ray

How is tendinopathy treated?

Like all soft tissue injuries, you can treat tendinopathy according to the RICER protocol for the first 2 days:

• Rest — not moving the affected area
• Ice — apply ice packs to the affected area
• Compression — apply compression bandages to the area
• Elevation — keep the injury raised
• Rehabilitation — take slow steps to recovery

There are also things you should avoid. You can follow the No HARM protocol:

• no Heat
• no Alcohol consumption
• no Running or physical activity
• no Massage

You should also avoid completely resting for more than 48 hours. Being inactive for too long can impact your recovery.

After the initial period, your doctor or physiotherapist can recommend the next steps in your recovery. These may include:

• pain relief
• stretching exercises
• changes in sports techniques and footwear to reduce stress on the tendon

Less commonly, you may need injections or surgery to treat tendinopathy.>

What are the complications of tendinopathy?

It's important to rest and follow a doctor's advice if you have tendinopathy. Ignoring your symptoms can:

• make your symptoms worse
• cause more damage to your tendon
• make your recovery take longer

Can tendinopathy be prevented?

Avoiding overusing your tendons can help prevent tendinopathy. Even tiny movements can cause tendinopathy when done repeatedly. This can include clicking a computer mouse.

If you need to do a repetitive action, pay attention to pain or swelling in or around your joints. Give your tendon time to heal and rest, especially if you feel any pain or discomfort.

You can also ask your doctor, physiotherapist or sports coach how to prevent injury.

Resources and support

For more information on tendinopathy, there are resources available.

You can read the NSW Government Agency for Clinical Innovation fact sheet on managing elbow tendinopathy (tennis and golfer's elbow) .

You can learn about Achilles tendon injuries on the Sports Medicine Australia website.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.