Tendinopathy: Understanding and Treating Chronic Tendon Pain

1. What Is Tendinopathy?

Tendinopathy is a common condition characterized by chronic tendon pain and impaired function, typically caused by repetitive overuse rather than acute injury. Instead of inflammation, the tendon undergoes degenerative changes—collagen fibers become disorganized, microscopic tears accumulate, and the tissue loses its ability to handle load.
This process can affect tendons throughout the body, including the rotator cuff (shoulder), tennis and golfer’s elbow, hamstring origin, patellar tendon, Achilles tendon, and plantar fascia. It often develops in people who perform repetitive activities—whether athletes, manual laborers, or anyone who increases their activity too quickly. Risk factors include poor biomechanics, obesity, metabolic disorders, and aging.

Tendinopathy is extremely common, accounting for up to 30–50% of overuse injuries in sports and affecting many adults who remain active later in life. Because tendons are slow to heal, symptoms can persist for months or years if not properly addressed.

2. Treatment Options

Initial management focuses on symptom relief and load modification:

• Activity modification and rest: Reduce or adapt activities that aggravate symptoms.
• NSAIDs: Provide short-term pain relief but don’t repair the tendon itself.
• Physical therapy: The cornerstone of treatment. Controlled, progressive loading—especially eccentric or heavy slow resistance exercises—stimulates tendon remodeling and strength. Multiple studies have shown these exercise programs significantly improve pain and function.

If conservative treatment isn’t enough, several minimally invasive interventions can promote healing:

• Extracorporeal Shockwave Therapy (ESWT): Delivers acoustic waves to stimulate tissue repair. Meta-analyses show moderate success, especially for Achilles and plantar fascia pain, with improvement rates around 60–80% after several sessions.
• Platelet-Rich Plasma (PRP): Uses growth factors from your own blood to trigger tendon healing. Clinical trials report superior long-term results for conditions like tennis elbow compared to other interventions, with better pain reduction and durability of effect.
• Percutaneous Tenotomy: A quick, ultrasound-guided procedure to remove diseased tendon tissue and jumpstart healing. Studies report 80–90% satisfaction and return to activity within weeks.
• Surgery: Reserved for severe or persistent cases after all other measures fail. Recovery can take months, but success rates remain high when appropriately indicated.

The right treatment depends on tendon location, severity, and response to load. The goal is always to restore the tendon’s strength and function—not just reduce pain.

3. The Point Performance Approach

At Point Performance, our team of rehabilitation, pain management, and sports medicine physicians, and physical therapists provides comprehensive, individualized care for tendon injuries. We don’t just treat symptoms—we identify and address the underlying cause. Through detailed examination, movement analysis, and real-time ultrasound imaging, we pinpoint the exact site and extent of tendon degeneration.

Dr. Keith DellaGrotta, a Georgetown University–trained sports medicine specialist, uses ultrasound-guided procedures to deliver precisely targeted treatments when appropriate. These may include PRP injections or percutaneous tenotomy—minimally invasive options that can effectively stimulate healing while minimizing downtime.

Our integrated approach combines regenerative therapies with expert rehabilitation to:

• Accelerate recovery
• Relieve pain without surgery
• Restore strength, flexibility, and confidence
• Prevent recurrence through education and exercise planning

Whether you’re an athlete, active adult, or simply want to move without pain, Point Performance can help you recover quickly and safely using the latest evidence-based techniques.