What’s The Key Difference Between Tendinitis & Tendinosis?

Tendinitis and tendinosis are two common conditions that affect the tendons. While they may sound similar, they are actually two different conditions with distinct causes and treatment protocols.

Tendinitis gets worse with exercise and specifically more reps and is characterized by inflammation of the tendon, usually caused by repetitive overuse. It typically presents with acute pain, swelling, and tenderness, and typically requires resting the movements causing pain and discomfort. Tennis elbow is a very common form of tendinitis in the elbow that may require resting certain upper body movements that cause discomfort.

Tendinosis is the opposite and gets better with exercise and more reps and is a chronic condition that results from the degeneration of the tendon tissue. It is often caused by repetitive microtrauma and does not involve significant inflammation. It is characterized by pain, stiffness, and weakness but does not get better with rest as the tendons need to be strengthened through exercise. Tendinosis is very common in knees and during certain exercises like squatting and running “that feel better after I warm up.”


Exercise and physical therapy are essential components of treatment for both tendinitis and tendinosis. However, the specific types of exercises and recovery protocols may differ depending on the underlying condition.

For tendonitis, the primary goal of exercise is to reduce inflammation and promote healing. Resting the area, ice, and anti-inflammatory medication may also be recommended. Once the inflammation has subsided, gentle range of motion exercises and stretching can help improve flexibility and mobility. Gradually reintroducing exercise, starting with low-impact activities and gradually increasing intensity and duration, can help rebuild strength and prevent a recurrence.

For tendinosis, the focus of exercise is on promoting healing and strengthening the injured tendon. Eccentric training, which involves lengthening the muscle/tendon while it is under load, has been found to be particularly effective for treating tendinosis. Heavy slow resistance (HSR) training, which involves performing slow, controlled movements with heavy weights, has also been found to be effective for treating tendinopathy.

One key factor in the recovery from any injury is to continue exercising in pain-free exercises and ranges of motion to stay fit, healthy, and promote bloodflow. Treatment may also include modifications to daily activities or work habits to prevent further injury.

In conclusion, while tendinitis and tendinosis may have some overlapping symptoms, they are two distinct conditions with different underlying causes and treatment protocols. Exercise and physical therapy are essential components of treatment for both conditions, but the specific types of exercises and recovery protocols may differ depending on the underlying condition. It’s important to work closely with a professional to help ensure an effective plan is established, reducing the risk of further injury and promoting healing.

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