Is tendonitis an inflammation? Well, not exactly.

elbow pain Studio On.

Introduction

The common belief is that a “tendonitis” simply means inflammation of a tendon. But clinical reality shows something different. At Studio On (Phnom Penh & online), we frequently see a process of mechanical overload and degeneration rather than classic inflammation.

Why “inflammation” is often the wrong label

Tendonitis suggests acute inflammatory response; yet many studies indicate tendinopathy involves structural tendon changes—collagen disorganization, new blood vessels, mechanical stress—not just inflammatory swelling. Treating it as mere inflammation often results in inappropriate rest and delayed recovery.

Why “inflammation” is often the wrong label

Tendonitis suggests acute inflammatory response; yet many studies indicate tendinopathy involves structural tendon changes—collagen disorganization, new blood vessels, mechanical stress—not just inflammatory swelling. Treating it as mere inflammation often results in inappropriate rest and delayed recovery.

Implications for physiotherapy rehabilitation

Tendonitis suggests acute inflammatory response; yet many studies indicate tendinopathy involves structural tendon changes—collagen disorganization, new blood vessels, mechanical stress—not just inflammatory swelling. Treating it as mere inflammation often results in inappropriate rest and delayed recovery.

Progressive Loading Is Key: Instead of stretching, the most effective treatment is progressive loading. This involves gradually increasing the load or resistance placed on the tendon over time, helping it adapt and strengthen. This approach helps rebuild the tendon’s capacity to handle stress without causing further damage.

3. Repetitive Motions and Tendinitis

Tendinitis is primarily a condition of overuse. Repetitive movements—whether from sports, work, or everyday activities—lead to microtrauma in the tendon. Over time, if the body doesn’t have adequate time to recover, this microtrauma accumulates and causes pain.

• The Key Is Rest and Proper Rehabilitation: During the acute phase of tendinitis, rest is crucial. It allows the tendon to recover from the initial strain. However, rest alone is not enough. Following the acute phase, targeted exercises focusing on strengthening the tendon are necessary to prevent further injury.

4. Managing Acute Tendinitis in Modern Physiotherapy

In the acute phase, it’s important to reduce load and modify activities that aggravate the tendon. Ice and pain relief medications can help manage symptoms, but they don’t address the underlying problem. Modern physiotherapy focuses on adjusting movement patterns and introducing progressive loading as soon as the pain allows.

5. Preventing Chronic Pain

One of the greatest risks of untreated or improperly managed tendinitis is that it can evolve into chronic pain. Chronic tendinopathy is not only more difficult to treat but also disrupts daily life significantly. To avoid this, it’s essential to begin a proper rehabilitation program early, focusing on reducing pain, restoring movement, and gradually reintroducing activities without causing further strain.

I provide structured and evidence-based online physiotherapy for patients worldwide, offering clinical assessment, diagnosis, and personalised rehabilitation.

I also receive patients in person at my physiotherapy clinic in Phnom Penh.

You can begin your online physiotherapy session through the dedicated platform:

https://www.studiohealthon.com/online-physiotherapy

More information on clinical standards and supporting evidence is available here:

https://www.studiohealthon.com/online-physiotherapy-clinical-evidence

Yannick Sarton, MSc Physiotherapist

International Online Physiotherapy & In-Clinic Care, Phnom Penh

References:

Malliaras P. Physiotherapy management of Achilles tendinopathy. J Physiother. 2022 Oct;68(4):221-237. doi: 10.1016/j.jphys.2022.09.010. Epub 2022 Oct 21. PMID: 36274038.

Millar NL, Silbernagel KG, Thorborg K, Kirwan PD, Galatz LM, Abrams GD, Murrell GAC, McInnes IB, Rodeo SA. Tendinopathy. Nat Rev Dis Primers. 2021 Jan 7;7(1):1. doi: 10.1038/s41572-020-00234-1. Erratum in: Nat Rev Dis Primers. 2021 Feb 3;7(1):10. doi: 10.1038/s41572-021-00251-8. PMID: 33414454.

Breda SJ, Oei EHG, Zwerver J, Visser E, Waarsing E, Krestin GP, de Vos RJ. Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy: a randomised clinical trial. Br J Sports Med. 2021 May;55(9):501-509. doi: 10.1136/bjsports-2020-103403. Epub 2020 Nov 20. PMID: 33219115; PMCID: PMC8070614.