Tendonitis

Tendonitis is inflammation or irritation of a tendon—the tough cord that connects muscle to bone—most often triggered by overuse or a sudden jump in activity. It can impact daily tasks and sports, but most people improve with prompt evaluation and targeted care. Cape Fear Valley Health provides comprehensive assessment and treatment to help you recover safely and reduce the risk of future flare-ups. Understanding the common symptoms of tendonitis and seeking timely care can shorten recovery and prevent complications.
 

Overview of Tendonitis

Tendonitis involves acute tendon inflammation caused by repetitive motion, overload, or direct injury. It differs from tendinosis, which reflects chronic tendon degeneration with less inflammation and more tendinotic changes, and from tenosynovitis, which affects the tendon’s surrounding sheath. Identifying the correct condition guides effective treatment and helps determine whether the tissue is acutely inflamed or primarily tendinotic.

Tendonitis can develop in many areas: the shoulder (rotator cuff), elbow (tennis or golfer’s elbow), wrist and thumb (De Quervain’s), hip (gluteal), knee (patellar or quadriceps), ankle, and Achilles tendon. Activity patterns often point to location: overhead sports are linked to shoulder pain, racquet and throwing sports to elbow issues, typing or gaming to wrist problems, and running or jumping to knee or Achilles pain. Hill running commonly aggravates the Achilles.

Risk factors include aging (tendons become less elastic), repetitive motions, sudden training spikes, poor biomechanics or muscle imbalances, and inadequate recovery. Medical conditions such as diabetes, rheumatoid arthritis, gout, and thyroid disease can increase risk, as can some medications (including fluoroquinolone antibiotics and aromatase inhibitors). Footwear, work ergonomics, and training surfaces also matter for reducing tendonitis and limiting progression to tendinotic changes.

Symptoms of Tendonitis

Common symptoms of tendonitis include focused pain that worsens with use, tenderness along the tendon, mild swelling or warmth, and stiffness or reduced motion. Some people notice a grating or crackling sensation with movement. Symptoms vary by site: shoulder tendonitis may cause night pain and difficulty lifting overhead; elbow tendonitis hurts with gripping or wrist movements; wrist and thumb tendonitis can be painful with lifting or pinching; patellar tendonitis often aches below the kneecap, especially with jumping; Achilles tendonitis leads to heel or lower-calf pain that’s worse with push-off or uphill activity. Recognising the symptoms of tendonitis early supports quicker recovery.

Seek urgent care if you feel or hear a pop with sudden, severe pain; cannot bear weight or lift the affected limb; or notice a visible deformity—these signs may indicate a tendon rupture. Redness, warmth, fever, or severe swelling could signal infection and require prompt evaluation. Schedule non-urgent care if pain lasts beyond a week of rest, interferes with work or sport, or keeps returning despite self-care.

Without treatment, tendonitis may progress to chronic pain, tendinosis with tendinotic degeneration, partial tears, and rarely complete rupture. Early management helps protect long-term function and prevents recurrent tendonitis.

Diagnosis of Tendonitis

Your clinician will review when symptoms started, activities that trigger pain, recent training or workload changes, prior injuries, and what eases or worsens symptoms. The exam checks for point tenderness, swelling, range-of-motion limits, weakness, and pain with resisted motion or tendon-specific maneuvers. Discussing the symptoms of tendonitis you’ve noticed helps tailor the exam.

Imaging is not always needed. X-rays do not show tendons but can reveal fractures, calcifications, or arthritis that may contribute to pain. Ultrasound can visualize tendon thickening, tears, and fluid in real time and can guide injections. MRI is reserved for suspected tears, persistent symptoms, or when surgery is being considered. If infection or an inflammatory condition is suspected, blood tests may be ordered, and imaging can help distinguish acute tendonitis from more chronic tendinotic changes.

At Cape Fear Valley, primary care, sports medicine, and orthopedic specialists collaborate to evaluate tendon problems. Most people start with nonoperative care. We may refer to orthopedics for complex tears or when conservative treatment fails, to sports medicine for imaging-guided procedures and return-to-activity planning, and to physical therapy for personalized exercise programs that restore strength and function.