Tendinitis and tendinosis: what are the differences?

Tendon injuries are very common in sports, and the terms ‘tendinitis’ and ‘tendinosis’ are often used interchangeably. However, they are different conditions with different treatments, and in order to achieve effective recovery and prevent relapses, it is important to know how to distinguish between them.

If you are interested in specialising in the rehabilitation of these injuries, the Master in Sports Physiotherapy or the Master in Sports Physiotherapy online at Real Madrid Graduate School – Universidad Europea will give you a theoretical and practical approach. To learn more about these two injuries and their differences, read on.

Differences between tendinitis and tendinosis

Although both are conditions that affect the tendons, tendinitis and tendinosis have different causes and treatments.

Tendinitis is an acute inflammation of the tendon due to excessive or repetitive strain. Its symptoms are pain, swelling and limited movement and, if not treated properly, it can develop into a chronic problem.

In contrast, tendinosis is a chronic degeneration of the tendon due to repeated micro-injuries from which the athlete has not recovered properly. Unlike tendinitis, there is no inflammation, but there is a progressive degradation of the tendon fibres, which can weaken the tendon and increase the risk of rupture.

Understanding these differences is essential to determine the most appropriate treatment and ensure that the athlete's recovery is as short as possible.

Common causes of these injuries in sport

Tendon injuries can occur for a variety of reasons. However, athletes are particularly prone to them due to the very nature of sport. Some of the most common causes of tendinitis and tendinosis are:

• Overuse and repetitive movements: sports such as tennis, swimming or running require repetitive movements that can wear down the tendons.
• Poor sports technique: in line with the above, incorrect execution of movements can put excessive strain on the tendons, which over time leads to injury.
• Lack of warm-up and stretching: not preparing the body properly before physical activity increases the risk of injury.
• Biomechanical and anatomical factors: some people are more likely to suffer from these conditions due to differences in their body alignment or muscle imbalances.
• Inappropriate use of sports equipment: wearing shoes without cushioning or using tennis rackets that are too heavy, for example, can put stress on the tendons.

Rehabilitation and treatment of tendinitis and tendinosis

Treatment for tendinitis and tendinosis must be tailored to the characteristics of each injury and should always be supervised by a sports physiotherapist. Below are some of the recommendations that are usually given to patients with these conditions.

Treatment of tendinitis

• Relative rest to avoid activity that causes inflammation.
• Cryotherapy to reduce pain and inflammation.
• Physical therapy, including mobility exercises and progressive strengthening.
• Use of anti-inflammatory drugs if necessary, always under medical supervision.
• Application of functional bandages or kinesiotaping to reduce the load on the affected tendon.

Tendinosis

• Eccentric exercises to promote the regeneration of tendon fibres.
• Manual therapies to improve tendon vascularisation.
• Treatments such as shock waves or dry needling to stimulate regeneration.
• Modification of the training load to allow for progressive adaptation of the tendon.

A well-structured treatment should include an appropriate progression of loads and functional exercises to facilitate a safe return to competition. The return to play approach is essential to ensure that the athlete returns to activity without risk of relapse.

Prevention of tendinitis and tendinosis in sport

Prevention plays a key role in the health of athletes. We have already explained the factors that can lead to these injuries. Consequently, for sports injury prevention it is recommended to:

• Monitor sporting technique to ensure movements are performed accurately.
• Warm up properly before training and stretch afterwards.
• Increase the intensity of training gradually.
• Include muscle strengthening and balance exercises.
• Use appropriate equipment in high-impact sports.
• Rest adequately and avoid excessive fatigue.

In addition, it is essential to control, evaluate and monitor physical and sports activity loads, as they can be both the source and the solution to many tendon disorders. Tendon injuries are usually caused by misuse or overuse, so proper load management can prevent and even resolve cases of tendinitis and tendinosis. Therefore, acquiring specific knowledge in this area is essential.

It is important to remember that sports physiotherapists are not only limited to treating injuries, but also to educating athletes on how to prevent them through physical therapy in sport.

The importance of training in sports physiotherapy

While general physiotherapy covers a wide range of medical conditions, sports physiotherapy focuses on the prevention, treatment and rehabilitation of specific sports injuries, adapting therapies to the demands of each discipline.

As we have seen, differentiating between tendinitis and tendinosis is essential for applying the right treatment and optimising the athlete's recovery. Given the high impact of tendon injuries on athletes' performance, having professionals trained in sports physiotherapy is crucial. If you are passionate about sports and want to be part of this sector, Universidad Europea offers various training options, such as the Online Physiotherapy Course among our portfolio of programmes. Take a look at the sports masters degrees on offer and boost your career.