What Is Tendinitis & How Do We Fix the Pain?

Tendon pain can be frustrating. It often lingers longer than expected, flares up during activity, and can make everyday movement uncomfortable. To understand how to fix it, we first need to understand what a tendon is and how it responds to stress.

Dr. Joe of PHYT Twinsburg dry needling for shoulder pain

What Is a Tendon?

A tendon is a dense band of connective tissue that attaches muscle to bone. Its job is to transfer force created by your muscles into movement.

If you have ever cooked chicken tenderloins, you have probably seen the tough white strip you have to cut away. That tissue closely resembles a tendon.

What Makes Tendons Unique?

Tendons are built to transmit force and store energy. Their stiffness or flexibility can vary from person to person, and that influences both performance and injury risk.

Stiffer Tendons

Stiffer tendons transfer force quickly and efficiently, which can be an advantage for explosive activities such as running, jumping, sprinting, and throwing. These tendons are often shorter and more powerful, but they may increase the risk of muscle strains because they absorb less stretch.

Less Stiff Tendons

More pliable tendons lengthen more easily and may be better suited for flexibility-based activities such as yoga or dance. They often provide better mobility, a greater range of motion, and may reduce strain risk. However, they are usually less effective at generating explosive power.

Why Do We Get Tendon Pain?

Tendon pain usually develops through a combination of overload, irritation, and reduced recovery.

Microtrauma and Overload

Small amounts of stress are normal and healthy. Tendons need stress to stay strong. When loading exceeds the body’s ability to recover, repeated microtrauma can accumulate. This may lead to inflammation, irritation, and pain.

Nerve Sensitization

If inflammation persists, the nearby nerves can become more reactive. This may cause tenderness to touch, sensitivity to pressure, and pain with movements that normally would not hurt.

Sometimes the tendon is no longer the only issue. The nervous system is involved as well.

Tissue Degeneration

When irritation continues for too long without proper treatment, the tendon’s collagen structure can begin to break down. This reduces the tendon’s strength and healing capacity.

Tendinitis vs Tendinosis

These terms are often used interchangeably, but they describe different stages of tendon problems.

Tendinitis

Tendinitis refers to inflammation of the tendon. It often causes pain during use, tenderness when pressed, and irritation after activity.

Tendinosis

Tendinosis refers to degeneration of the tendon’s collagen fibers over time. It usually develops when healing and inflammation have been poorly managed for a prolonged period.

How Do We Fix Tendon Pain?

The right treatment depends on why the tendon hurts.

If the Problem Is Tendon Stiffness or Load Tolerance

If you are naturally powerful, explosive, or tight, long duration isometric holds can help improve tendon tolerance and reduce pain. Movements such as squat holds, split squat holds, or push up holds can build strength without excessive joint movement.

If you are naturally hypermobile or flexible, progressive strength training and eventually plyometric work can help improve tendon stiffness and force transfer. Weightlifting, controlled jumping drills, and landing mechanics training are often useful tools.

In both groups, the key is proper dosage. The tendon needs enough load to stimulate adaptation, but not so much that recovery falls behind.

If the Nervous System Is Involved

Sometimes the tendon is not the only structure irritated. Pain may come from local tissue irritation, nerve irritation somewhere along its path, stress system imbalance, or long-standing pain that changes how the brain processes signals.

This is where a skilled clinician can help determine the main driver of symptoms. (*cough* shameless plug for PHYT For Function cough)

If the Tendon Has Degenerated

When tendon tissue quality has declined, the goal becomes rebuilding collagen and restoring function. Progressive loading remains one of the most effective tools. This may include isometrics, eccentric exercises, and slow resistance training. Dry needling may also help stimulate fibroblasts and tissue remodeling. Blood flow restriction training can also deliver many of the benefits of high-intensity exercise with lighter loads, making it useful when pain limits traditional training.

Nutrition Matters

Your body needs the right raw materials to rebuild connective tissue. A practical strategy is consuming collagen or gelatin along with vitamin C about 30 to 60 minutes before exercise. Vitamin C supports collagen-building pathways, while collagen provides amino acids needed for tendon repair.

Final Thoughts

Tendinitis is rarely just inflammation. It often involves poor load management, nervous system se

nsitivity, reduced tissue quality, and recovery deficits. That is why rest alone often fails. The best treatment is usually a smart progressive plan that matches your body type, movement demands, and stage of injury. If your tendon pain has lasted more than a few weeks, getting an individualized assessment can save you months of frustration (wink, wink; nudge, nudge. Book online at phyt.janeapp.com!).