Tendinitis and tendinosis - What's the difference?

Many of us have suffered tendon injuries in sport, commonly affecting the shoulder, elbow, knee or ankle. But what actually happens when the tendon becomes injured, and how long are you expected to be recovering for?

When a tendon becomes injured, you're more than likely to be experiencing pain, decreased strength and flexibility.... but is this tendinitis or tendinosis?

Tendinitis occurs when the tendon is inflamed in response to micro-tears from overload. The period of acute injury and inflammation would be indicative of a tendinitis picture, where you should be resting, icing and making lifestyle changes to allow the injury to settle.

Tendinosis is far more common, and is characterised by a degenerative change in the tendon's collagen in response to chronic overuse. If a tendinitis injury is not allowed to recovery adequately, then tendinosis will ensue, changing the structural integrity of the tissue. Tendinosis is non-inflammatory, where tendinitis does invoke inflammatory cascades. It important to effectively diagnose the injury, as this will impact on the appropriate management.

The healing time for tendinitis is several days to 6 weeks, where as tendinosis injuries can endure for 6-10 weeks if addressed in the early stages. Chronic tendinosis injuries can take as long as 3-6 months to recover, and treatment can take as long as 9 months.

Managing tendinitis injuries will usually involve reducing inflammation with ice packs and anti-inflammatories. However, in tendinosis injuries anti-inflammatories and corticosteroid injections are contraindicated as they inhibit collagen repair.

Tendinosis injuries are more challenging to manage and are individual to the patient, but may incorporate the following factors:

# Rest

# Optimising function and removing aggravating activities

# Taping or bracing

# Flexibility and/or strengthening

# Ice/heat

# Massage

# Vitamin C, manganese and zinc supplementation

Early intervention is crucial with any injury, and reduces the likelihood of re-injury occurring.