Common causes
- A change in training volume, intensity or technique that exceeds tendon tolerance.
- Occupational repetition, including gripping, lifting or keyboard-related demand.
- Reduced recovery between bouts of loading.
- Age-related changes in tendon structure and healing capacity.
- Metabolic factors that can influence tendon health.
How we evaluate
History addresses the activity changes that preceded symptoms, previous treatments and the demands of work and sport. A hands-on osteopathic and physiatric examination localizes the painful tendon, tests its loading capacity and assesses the joints and movement patterns above and below it. Diagnostic ultrasound can show tendon structure and guide selected procedures, while EMG/NCS is considered only when a nerve problem is suspected. A sudden pop with weakness or a palpable gap may indicate a tear that needs prompt imaging or surgical assessment.
Treatment options
we may discuss.
Performance Health / rehabilitation
Progressive loading is the best-supported treatment for most tendinopathies, with isometric, slow resistance and functional stages matched to the tendon and the person's goals. Adjacent weakness and technique are addressed alongside the tendon itself. Most tendon pain can be managed without surgery; a surgical opinion is sought only for significant tears or persistent pain after a thorough loading program.
Regenerative & Cell-Based Medicine
When appropriate, PRP may be discussed for selected tendinopathies, with evidence that varies by tendon and study quality. Prolotherapy may be considered for selected ligament-related problems. Cell-based and biologic options require a separate review of evidence, risks and applicable law. Regenerative care is combined with progressive rehabilitation, not offered instead of it.
Targeted Pain Management
Medication review and precise, ultrasound-guided procedures may support selected cases. Steroid injections near tendons are used cautiously because repeated injections can weaken tendon tissue, and they are not a first-line treatment for tendinopathy. Nerve-targeted procedures are reserved for a relevant focal indication. Procedures are image-guided, using ultrasound or X-ray guidance depending on the target.
Related treatments
From the Journal
Related conditions
Common
questions.
When to seek
care urgently.
Seek urgent care for a sudden pop with inability to push off, lift or grip, a visible tendon gap or deformity, or severe swelling with numbness or color change.
This page is general information, not medical advice. Individual results vary. Medical Disclaimer