Tendinopathy: Causes, Treatments, and What You Need to Know

When your tendon hurts—not just after a workout, but for weeks or months—you’re not dealing with simple inflammation. You’re likely dealing with tendinopathy, a degenerative condition of the tendon caused by overuse and poor healing response. Also known as tendonosis, it’s not the same as tendinitis, which is rare in adults. Tendinopathy is about structural breakdown, not swelling. This is why ice and anti-inflammatories often don’t fix it. The tendon isn’t inflamed—it’s tired, frayed, and struggling to repair itself.

Most cases happen in places under constant stress: the Achilles, patellar tendon, rotator cuff, and tennis elbow. Runners get it in the Achilles. Jumpers in the knee. Office workers in the wrist. It’s not just athletes—it’s anyone who repeats the same motion too often without enough recovery. The body tries to heal, but if the load keeps coming, the tendon fibers get weaker, not stronger. That’s why rest alone rarely works. You need to reload it the right way—gradually, with controlled stress—to rebuild it.

What helps? Eccentric exercises are the gold standard. For example, lowering your heel slowly off a step for Achilles tendinopathy. Or holding a weight while slowly lowering your arm for shoulder tendinopathy. Physical therapy isn’t just massage—it’s science-backed loading. Shockwave therapy, platelet-rich plasma, and even certain supplements like collagen with vitamin C have shown promise in studies. But no treatment works if you keep doing the thing that broke it in the first place.

And here’s the thing: tendinopathy doesn’t show up well on MRIs or ultrasounds early on. That’s why people get told it’s "just a strain" and sent home. But the pain is real. The tendon is changing. And ignoring it makes it worse. The good news? With the right approach, most people get better—even after years of pain. It just takes patience and the right plan.

Below, you’ll find real-world guides on how to manage tendon pain, what treatments actually work, how medications interact with recovery, and why some "quick fixes" make things worse. These aren’t generic tips. They’re based on what patients and doctors are seeing now—what helps, what doesn’t, and what to ask your provider next.