Tendinopathy

You don’t have to play sports to have a tendon problem. Gardening, carpentry, raking or shoveling — even cleaning the house — can lead to tendon pain.

When a tendon in your body becomes inflamed (tendinitis) or when the collagen (protein) in the tendon starts to break down (tendinosis), chances are you’ll know. The pain can be sudden or develop gradually. You might feel it in your elbow, ankle, hip, shoulder or knee. Tendon problems can affect anyone who puts lots of stress on their joints. And this pain can really impact your daily life.

Cleveland Clinic orthopaedic specialists can help treat whatever tendon problems you have so you can get back to the gym, plant those flowers — even clean the house again — with as little pain as possible.

Why Choose Cleveland Clinic for Tendinopathy Care?

Demonstrated expertise:

Cleveland Clinic is a national leader in bone, muscle and joint care. Our orthopaedic providers are experts at caring for patients with musculoskeletal issues — from common conditions to the most complex bone, joint or connective tissue disorders. Meet our team.

Trusted experts:

You’re an important and valued part of our team at Cleveland Clinic. That’s why we take the time to explain exactly what your condition is and what your treatment options are. We welcome your questions and never want you to feel rushed. It’s our goal to keep you in the loop and on top of your care.

Innovation and research:

Our ongoing research leads to the newest and most advanced treatment options, including minimally invasive, tissue-sparing and robotic procedures.

National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Virtual visits:

Not all appointments have to be in-person. Sometimes, you can do your initial visit or a quick follow-up as an online virtual visit. All you need is an internet connection and a smartphone, computer or tablet to meet with your provider one-one-one from home, work or even your favorite coffee shop.

Tendinopathy Diagnosis at Cleveland Clinic

Tendinopathy broadly describes tendon conditions that cause pain and swelling. This includes tendinitis (inflammation of your tendon) and tendinosis (a breakdown of the collagen fibers in your tendon). While both have similar symptoms, many of the treatment options for each are different, so it’s important to get the right diagnosis.

Common tendinopathies can affect your foot and ankle (Achilles and plantar fascia), your kneecap (patellar and quad tendons), your shoulder (rotator cuff), your hip (gluteal and hamstring tendons), your wrist and thumb or your elbow (golfer’s elbow or tennis elbow).

Meet our team

Your care doesn’t happen in a vacuum. And when you come to Cleveland Clinic, you get a team of skilled providers who work together to pinpoint your diagnosis and then deliver care that’s specific to you.

Depending on your needs, this team could include:

Orthopaedists.
Surgeons.
Oncologists.
Radiologists who specialize in musculoskeletal system diagnosis.
Rheumatologists.
Physical therapists.
Sports health specialists and therapists.

What to expect at your first visit

At your first appointment, your healthcare provider will ask about your medical history. They’ll want to know about your pain — where it is, how long you’ve had it and if it’s burning, dull or sharp. They’ll also do a physical exam to look for swelling, tenderness and to test your range of motion (how far you can stretch or move parts of your body). Your provider might also ask:

Do you play sports?
What are your daily activities and how are they affected?
Have you tried any at-home treatments?

Imaging tests

Imaging tests can help us take a closer look at what’s going on. Tests can include:

Musculoskeletal ultrasound: This special ultrasound uses high-frequency sound waves to take pictures of your tendon. It will show the swelling and inflammation from tendinitis or the chronic (lifelong) degenerative changes (collagen breakdown) found in tendinosis.
Magnetic resonance imaging (MRI): An MRI uses powerful magnets to take detailed pictures of your tendon. It can show us if you have any injuries to your tendon.

Providers Who Perform Tendinopathy

Locations

Our healthcare providers see patients at convenient locations throughout Northeast Ohio, Florida and London.

Tendinopathy Treatment at Cleveland Clinic

When it comes to crafting a treatment plan, we personalize it specifically for you. Treatment depends on what type of tendinopathy you have and which tendon is bothering you. Treatment for tendinitis isn’t the same as treatment for tendinosis.

Tendinitis treatments

The common treatments for tendinitis include:

Rest: Taking short breaks from motions you do over and over can help relieve pain.
Anti-inflammatory medications: Over-the-counter (OTC) medicines, like ibuprofen (Advil^® or Motrin^®) can help with swelling.
Steroid injections: Steroid shots can reduce your swelling and help lessen your pain for a while, but they aren’t a long-term solution.
Orthotics, splints and braces: Shoe inserts, splints, braces and elbow banks protect your tendons and can reduce the stress you put on them.
Physical therapy: A physical therapist can show you the right way to stretch and gradually strengthen your muscles.
Massage: Massage can reduce your pain, relax you, help increase your strength and encourage your body to make collagen.
Acupuncture: Your provider will put very thin steel needles in your skin to stimulate the affected area.
Platelet-rich plasma injection: Your provider will give you platelets to encourage healing.
Extracorporeal shockwave therapy (ESWT): Your provider will use a handheld device to deliver high-energy sound waves to stimulate blood flow to the affected area and encourage healing.

Tendinosis treatments

The common treatments for tendinosis include:

Rest: Taking short breaks from repetitive tasks can help relieve pain.
Ice: Applying an ice pack or cold compress to the affected area can reduce swelling.
Eccentric strengthening: This exercise, which involves tightening your muscle while you hold something heavy, helps to strengthen your tendon and stimulate collagen production.
Stretching: Stretching keeps you flexible, increases circulation and reduces tightness in your tendon.
Massage: Massage can reduce your pain, promote relaxation, increase your strength and stimulate your body to make collagen.
Supplements: Certain vitamins can keep tendons healthy. Your provider can advise you on which ones to take and the right dosages.

Minimally invasive hydroresection

If your pain lasts for six months after trying the above treatment options, your healthcare provider might recommend a minimally-invasive surgery. This office-based procedure removes the degenerative material that’s causing your tendon to swell.

Taking the Next Step

Tendon pain is common but treatable. And there’s no reason to live with it. If one of your tendons is causing you problems, Cleveland Clinic’s experts can help. We can create a treatment plan that matches your needs and works for you — putting pain behind you and getting back to the things you love to do.