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Tendon Injuries Explained: Causes, Diagnosis, and Treatment Options

What Are Tendon Injuries?

Tendons serve as the vital connectors between muscles and bones, enabling movement and stability throughout the body. When healthy, these strong fibrous tissues endure tremendous stress daily. But once overworked, injured, or weakened, they can become a primary source of pain and disability.

Tendon injuries, commonly referred to as tendinopathies, range from mild inflammation (tendonitis) to chronic degeneration (tendinosis), and in more severe cases, complete tears (tendon ruptures). These injuries are especially common in athletes, individuals with physically demanding jobs, and older adults.

At South Florida Multispecialty Hospital, we frequently see patients struggling with undiagnosed tendon issues that limit mobility and quality of life. The good news? With proper care, most of these injuries are treatable, and often preventable.


Types of Tendon Injuries: Tendonitis, Tendinosis, and Tendon Ruptures

Understanding the differences between tendon injury types is essential for successful treatment.

Tendonitis

This is the most familiar form, acute inflammation due to repetitive stress or sudden overload. For example, someone new to tennis might develop elbow pain after overusing their arm during multiple matches.

Tendinosis

Chronic and degenerative in nature, tendinosis refers to the gradual breakdown of tendon cells, often without any inflammation. It usually develops over weeks or months and is common in people who ignore initial symptoms or continue training without modification.

Tendon Ruptures

Complete or partial tendon tears are often sudden and painful. They frequently occur in tendons like the Achilles or biceps and often require surgical repair.


Who Is at Risk? Understanding the Risk Factors

We’ve treated patients as young as teenagers and as seasoned as retirees with tendon injuries, but certain risk factors increase susceptibility:

  • Aging naturally reduces tendon strength and blood supply
  • Repetitive movements at work or play increase strain
  • Poor form during exercise or inadequate warm-up routines
  • Autoimmune conditions like rheumatoid arthritis
  • Hormonal changes, especially in postmenopausal women
  • Diabetes, which has been linked to tendon degeneration

In athletes, overuse injuries account for nearly half of all tendon problems. In our clinical experience, those training for marathons or competitive sports often overlook rest days, one of the simplest and most effective prevention tools.


How Are Tendon Injuries Diagnosed?

Diagnosis starts with a detailed history, when pain began, activity patterns, and whether swelling or joint stiffness is present. A hands-on physical exam can reveal localized tenderness, weakness, or restricted range of motion.

For example, a patient might report persistent shoulder pain while reaching behind their back. Palpation might reveal tenderness in the rotator cuff tendons.

Once we have a clinical suspicion, we often refer the patient for imaging to confirm the diagnosis.


The Role of Imaging: Ultrasound and MRI in Diagnosis

Ultrasound is often our first choice, it’s dynamic, non-invasive, and cost-effective. It helps us evaluate the structure of the tendon, inflammation, and fluid buildup in real time.

MRI offers a more detailed image, especially in deep or complex anatomical areas like the hip or shoulder. It can also distinguish between tendinosis and true tears.

Timely and accurate imaging makes a huge difference. We’ve seen patients avoid surgery solely because imaging helped us catch the injury early enough for conservative treatment to work.


Non-Surgical Treatment Options and Rehabilitation

For most tendon injuries, surgery isn’t the first answer, it’s the backup plan.

Conservative care focuses on pain relief, restoring function, and preventing recurrence. Initial steps include:

  • Rest: Avoiding the activity that triggered the injury
  • Ice: 15–20 minutes, 3–4 times a day to reduce swelling
  • Compression: Braces or wraps, especially for weight-bearing tendons
  • Elevation: Particularly helpful for lower extremity injuries

Physical Therapy

We collaborate closely with physical therapists who design custom rehab programs centered on strengthening, stretching, and improving range of motion.

A real-life success story involved a high school baseball player with rotator cuff tendonitis. With six weeks of consistent PT and modification of his throwing technique, he returned to play, without surgery.

Medications

Nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen help relieve pain and reduce swelling.

In some cases, brief corticosteroid injections provide fast relief, though they’re not used for chronic tendinosis due to risk of further damage.


Surgical Interventions: When Are They Necessary?

When conservative treatment fails after 3–6 months, or if a complete tendon rupture is diagnosed, surgery becomes a viable option.

Common procedures include:

  • Debridement: Removing damaged tendon fibers (used in chronic tendinosis)
  • Tendon repair: Reattaching torn ends
  • Tendon grafting or transfer for severe, poorly healing cases

Rehabilitation after surgery is intensive but absolutely crucial. Our orthopedic team co-manages post-op care with physical therapists to ensure a smooth journey from incision to full recovery.


Innovative Therapies: PRP and Beyond in Tendon Healing

Emerging biologic treatments are transforming how we manage tendon disease.

Platelet-Rich Plasma (PRP)

PRP therapy involves drawing the patient’s blood, concentrating the platelets, and injecting them into the damaged tendon. Platelets contain growth factors that promote healing.

Some studies show PRP accelerates healing in chronic tendinosis of the elbow or Achilles tendon. We’ve used it for weekend warriors and pro athletes alike, with promising results.

Other Innovations

  • Shockwave Therapy
  • Stem cell-based treatments
  • Tenex (ultrasound-guided microdebridement for tendinosis)

These techniques may not be right for everyone but offer hope, especially when standard methods fall short.


Preventative Measures: Strengthening and Stretching for Tendon Health

We strongly believe that the best injury is the one you never have to treat. Prevention should be part of every wellness plan.

Here’s what works:

  • Regular stretching before and after activity
  • Strengthening supportive muscles around major joints
  • Cross-training to avoid repetitive strain
  • Ergonomic adjustments at work (keyboard height, mouse position, etc.)
  • Gradual progression in athletic training rather than sudden intensity bursts

For our older patients, simple routines like resistance band exercises and daily walking reduce the risk of tendon degeneration.


If you’re experiencing persistent tendon pain, stiffness, or weakness, don’t push through it. Let our experienced team at South Florida Multispecialty Hospital assess your symptoms and guide your recovery.


Frequently Asked Questions

Tendon injuries often result from overuse, aging, or trauma. Athletes, older adults, and people with chronic conditions like diabetes or arthritis are more vulnerable.

Tendonitis causes dull, aching pain and swelling, while ruptures often involve sudden, severe pain followed by weakness or difficulty moving the affected area.

After a physical exam, your doctor may order imaging tests like ultrasound or MRI to confirm the diagnosis and assess severity.

Rest, ice, anti-inflammatory medications, physical therapy, and sometimes corticosteroid injections are standard. Recovery time varies by location and severity.

Surgery is usually recommended for complete tendon ruptures, or chronic tendinosis unresponsive to conservative treatment after several months.

Minor injuries may heal in a few weeks, while moderate to severe injuries can take 3–6 months. Post-surgical recovery may take longer with rehabilitation.

Yes. Tailored exercise programs strengthen muscles, improve flexibility, and correct movement patterns, reducing the likelihood of recurrence.

PRP offers a regenerative approach, promoting natural healing without surgery. It’s especially useful for chronic cases when other treatments fail.

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