What is tendinosis?

Tendinosis is when your tendon gets worn out and damaged from overuse.

Tendons are strong bands of tissue that connect your muscles to your bones. They help your joints move and support your muscles.

You can develop tendinosis in many parts of your body. A common type of tendinosis is lateral elbow tendinosis (LET), also known as tennis elbow. This causes pain on the outside of your elbow.

How is tendinosis different from tendinitis and tendinopathy?

Tendinosis is not the same as tendinitis or tendinopathy.

Tendinitis is when your tendon is inflamed, swollen and sore. A tendon can become inflamed when it is suddenly overloaded or injured, causing small tears in it. The damage is usually short-term, and your recovery can be quick.

With tendinosis, your tendon shows signs of long-term damage. Your tendon is not swollen or inflamed, but it breaks down over time.

Tendinopathy is a general term to describe different types of painful tendon conditions. If you have tendinopathy, your tendon does not work well or doesn't recover after an injury. Tendinitis and tendinosis are types of tendinopathies.

What are the symptoms of tendinosis?

If you are living with tendinosis, your symptoms may include:

• pain and burning when you use your injured tendon during day-to-day activities
• reduced strength and flexibility in your affected limb, making it harder to move
• tenderness when pressing on your sore area

What causes tendinosis?

Tendinosis is caused when you use your tendon too much without giving it enough time to rest and heal. This causes damage to slowly build up over time.

Even tiny movements that you constantly repeat, such as clicking your mouse or typing, can cause tendinosis.

Some health conditions or lifestyle choices can increase your risk of developing tendinosis, especially lateral elbow tendinosis, including:

• smoking
• living with obesity
• playing racquet sports

The cause of tendinosis may be related to your work or hobbies. For example, tendinosis is more common in people whose jobs involve repeated gripping or wrist movements. If you play tennis or other racquet sports, check to see if you're overusing a one-handed backhand, using a racquet that's too heavy or a small grip size, as these might be causing your pain.

When should I see my doctor?

You should see your doctor if you:

• have symptoms of tendinosis, for example pain, that limits your work or hobbies
• are receiving treatment for tendinosis, but it's not helping your symptoms

How is tendinosis diagnosed?

Your doctor can diagnose tendinosis by:

• asking about your symptoms, medical history and lifestyle
• examining you — your doctor may stretch, contract or move your affected limb to see how movement affects you

Usually, you will not need to do imaging tests. Your doctor may refer you for an ultrasound or MRI (magnetic resonance imaging) scan if:

• your symptoms aren't improving with treatment
• your tendinosis is complex
• they want to rule out other conditions that could be causing your symptoms

It's important to rule out other conditions and get an accurate diagnosis of tendinosis. Sometimes, tendinosis can be misdiagnosed as tendinitis. These conditions are treated differently and take different times to heal.

Treatment for tendinitis includes medicines such as non-steroidal anti-inflammatory drugs (NSAIDs). These medicines are not recommended if you have tendinosis. The wrong diagnosis can affect your treatment and long-term recovery.

How is tendinosis treated?

Treatment for tendinosis includes one or more of the following:

• Resting as much as you can — if you are doing repetitive work tasks, take breaks. For example, take a break every 15 minutes, for one minute, or take a 5-minute break every 20 to 30 minutes. Your doctor or physiotherapist can guide you.
• Stretching, moving and massage therapy — gently stretching and moving your injured limb within your natural range of motion can help prevent your muscles from shortening. Stretching and moving your body can also improve your blood flow and help you recover. A qualified massage therapist or physiotherapist can show you how to stretch and move your body safely.
• Making small changes to your posture, how you move, work and sit — this can make a big difference to the impact your activities have on your body. Your physiotherapist can suggest changes you need, based on your situation.
• Using a support brace or tape can help reduce stress or pressure on your tendon.
• Ice — after doing activities where you used your tendon, apply an ice pack covered in cloth for 15 to 20 minutes a few times a day.
• Steroid injection — this is a type of anti-inflammatory treatment.
• Surgery — if your symptoms do not improve after 3 to 6 months of treatment, your doctor may recommend surgery.

The aim of your treatment is to stop constantly injuring and damaging your tendon and to let it heal. Listen to your body, and stop if an activity causes you pain.

Depending on your symptoms and how severe your tendinosis is, your doctor may refer you to a sports doctor or physiotherapist.

What are the complications of tendinosis?

If tendinosis isn't treated early, it can become chronic (long term). This happens because your muscle shrinks when pain prevents you from using it much — it might take many months to heal.

Tendinosis can also contribute to developing:

• tendinitis
• carpal tunnel syndrome
• other problems with your nerves

Can tendinosis be prevented?

You can try to prevent tendinosis by avoiding overusing your tendons and taking care of your health. Here are some tips:

• Take regular breaks when doing repetitive tasks, such as typing, lifting or using tools.
• Strengthen and stretch your muscles and tendons to keep them healthy and flexible.
• Listen to your body. If you feel pain or tightness, rest and avoid pushing through.
• Use the right techniques when playing sport or working.
• Try to live a healthy lifestyle — quit smoking and keep a healthy weight.

Resources and support

• Learn more about different muscle and tendon problems from the Queensland Government.
• Musculoskeletal Australia has a collection of resources to help you live well with a musculoskeletal condition.

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

Aboriginal and/or Torres Strait Islander peoples

Find an Aboriginal Community Controlled Health Organisation (ACCHO) or Affiliate near you.

Other languages

Smoking increases your risk of developing tendinosis. For quitting support, call Quitline on 13 7848. If you need an interpreter, you can request one and Quitline will call you back with an interpreter in your language.