What is tendinitis

Tendinitis is a collective term for tendon pathology accompanied by load-related pain. A tendon is a dense collagen structure connecting muscle to bone. It has poor blood supply and therefore heals slowly.

Repetitive overload

Sports, occupational, daily loads. Microtrauma to collagen fibers accumulates faster than the tendon can regenerate.

Age-related changes

After 40 the collagen composition changes (more type I, less type III), elasticity decreases. Tendinopathies become common even without heavy loading.

Anatomic factors

Impingement syndromes (shoulder, hip), limb axis issues, weak stabilizer muscles — create chronic tendon conflict with surrounding structures.

Metabolic factors

Diabetes, hypercholesterolemia, gout, fluoroquinolone use — degrade collagen quality and raise spontaneous rupture risk.

Tendinitis vs tendinosis

Tendinitis (acute)

Acute inflammation of the tendon or its sheath. Lasts up to 6 weeks. Inflammatory response present: swelling, redness, rest pain. Typical example — de Quervain's tendinitis after unusual loading.

Tendinosis (chronic)

Chronic degeneration without classic inflammation. Lasts > 3 months. Structural collagen disorder, neovascularization on ultrasound. Most "tendinitis" in athletes is actually tendinosis.

Tendon tear

Complete or partial. Complete — function loss, surgery required. Partial — Regenerative treatment may stimulate regeneration. Decision via MRI and ultrasound.

Common locations

Shoulder — rotator cuff

Supraspinatus tendinitis is the most common cause of shoulder pain. Pain on abduction 60–120°, night pain. → More

Tennis elbow (lateral epicondylitis)

Lateral epicondylitis — pain on the outer elbow with grip and wrist extension. Not only in tennis players — office workers too. Regenerative treatment injects the degeneration zone under ultrasound.

Golfer's elbow (medial epicondylitis)

Pain on the inner elbow with gripping. Same treatment principles as lateral epicondylitis.

Achilles tendinopathy

Achilles tendon tendinopathy. Typical for runners. Pain 2–6 cm from insertion. Ultrasound-guided CGF — standard protocol.

Plantar fasciitis

Technically a fasciopathy, but the same mechanism. Morning heel pain. → More

Runner's / jumper's knee

Patellar tendinopathy. Pain below the kneecap. A common cause of leaving sport — with regenerative methods most return.

De Quervain's

Tenosynovitis of the first extensor compartment at the wrist. Common in young mothers. → More

Trigger finger

Stenosing flexor tenosynovitis. Click on finger flexion. Targeted injection at the A1 pulley.

Tendinitis diagnosis

Clinical examination

Specific tests for each location: Tinel for de Quervain's, Jobe for supraspinatus, Thompson for Achilles. Assessment of pain on load and at rest.

Ultrasound — method of choice

Visualizes tendon structure, thickening, hypoechoic zones, calcifications, neovascularization (Doppler). Also used for image-guided injection.

MRI

If a partial or full tear is suspected, ultrasound is equivocal, or comorbid lesions are sought (meniscus with patellar tendinopathy, rotator cuff with shoulder pathology).

Tendinitis treatment with regenerative methods

The key principle is regeneration, not pain masking. Steroids are not used in regenerative treatment: they relieve pain quickly but weaken the tendon and raise the risk of spontaneous rupture.

PRP — for acute and mild forms

Platelet-rich plasma. Stimulates collagen regeneration. 2–3 sessions with a 2–4 week interval.

CGF — for chronic tendinosis

Concentrated growth factors in a fibrin matrix. Longer and stronger effect. Standard for Achilles tendinopathy, epicondylitis, de Quervain's.

Tenotomy + PRP

Under ultrasound — needle microperforation of the degeneration zone with simultaneous PRP injection. Effective for calcifying forms.

Shock-wave therapy

Adjunct to regenerative treatment for calcifying supraspinatus tendinitis and plantar fasciitis. The combined protocol gives the best results.

85%+Improvement without surgery
2–3Sessions per course
6–12 wkReturn to sport
0Steroids in protocol

Clinic and method matching — free of charge

Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within two working days.

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Frequently asked questions

Tendinitis vs tendinosis?

Tendinitis — acute inflammation. Tendinosis — chronic degeneration. Often coexist. Regenerative treatment works for both.

Can steroids be injected into a tendon?

They relieve pain quickly but weaken the tendon and increase rupture risk. Regenerative treatment does not use them — only PRP and CGF.

How long does treatment take?

Acute — 3–6 weeks, chronic — 2–4 months. Usually 2–3 injections with a 2–4 week interval.

Is surgery needed for a tear?

Complete tear with loss of function — yes. Partial tear — usually no.

What is shock-wave therapy?

A physical therapy method that complements regenerative treatment for calcifying tendinitis and fasciitis.