tendinitis + tendinosis; what’s the difference?

hip-bursitis-s2a-what-is-bursitisIf you’ve participated in any form of athletics or have a job that involves repetitive motion, you’ve probably heard the term tendinitis (or tendonitis depending on your spelling preference: both are correct terms). Tendinitis, in it’s true form, means inflammation of a tendon. A tendon is fibrous connective tissue that attaches muscle to bone. They are often under a great deal of stress and more so when a muscle is not firing properly. Tendons typically have a very poor blood supply and thus take much longer to heal than something exposed to a generous blood supply. This creates an environment ripe for injury. Common sites of tendinitis are the shoulder, Achilles, and elbow. Typically if a true tendinitis is caught/addressed at the start of the process- rest from activity (1-3 weeks), sticking to an anti-inflammatory diet (omega 3s, limiting sugar, refined foods, etc) and stretching are enough to take care of the problem.

Issues set in when a tendinitis is not addressed quickly enough and progresses into a tendinosis. Many people think they are dealing with a tendinitis issue but have actually slid into tendinosis territory. So what difference does a suffix make? Well, a big one. When you’re dealing with an -osis you are now dealing with degenerative changes on a cellular level NOT an active inflammatory process. No inflammation, no healing. When the inflammatory cascade is happening- the body is trying to fix itself, it’s laying down collagen and scar tissue. Inflammation, under control, is not a bad thing. Inflammation NOT in control is problematic. There’s a very fine line to walk. So when you’ve ventured from tendinitis to tendinosis- inflammation has stopped and micro tearing has taken over.  This is when you open yourself up to larger tears or ruptures, and I think we can all agree we’d like to avoid those.

Addressing the Achilles tendon with Graston Technique
Addressing the Achilles tendon with Graston Technique

So how do you know if you’re dealing with an -osis vs an -itis? Advanced imaging (MRI) will visualize these microscopic changes but a general rule of thumb is that an -osis tends not to respond to rest. So once you’ve taken time off and get back at it, your issues start up again. If you’ve been dealing an issue for more than 3 weeks, it’s time to enlist some outside help.

Sports chiropractors and physical therapist are trained to deal with soft tissue injuries including tendinitis and tendinosis. Twin Cities Spine + Sports handles these issues through addressing the tissues with manual therapy, modifying activities while things calm down and putting together a specific rehab plan for each case. Tendinosis injuries are often frustrating for patients (rightfully so) and certainly take some time (it didn’t start overnight, it’s not going away overnight!) but with proper care many can be treated conservatively before more invasive measures need to be taken.

Dealing with what you think may be a tendinitis issue? Contact us today!

Dr. Katie Clare, DC, CCSP, ART

Dauntless Sport & Spine Clinic
4510 W. 77th St, Edina, MN 55435
952.831.0242
dauntlessclinic.com

References:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312643/

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