When tendon pain won't go away, there's usually more to the story. Tendon pain can start as a small annoyance, but when it keeps coming back, limits your workouts, or makes everyday activities uncomfortable, it can become frustrating.
Tendinopathy is a common condition caused by changes and irritation within a tendon, often from repeated stress, poor movement mechanics, or not allowing the tissue enough time to recover. This can cause micro-tears in the tendon which leads to weakness and fatigue.
Typical NSAID’s and corticosteroids reduce pain and other tendinopathy symptoms but halts the healing process. The tendinosis almost never fully heals with these options mainly due to the limited collagen synthesis and lack of proper rehabilitation which is why pain keeps coming back!
Understanding what is contributing to your tendon pain is the first step toward getting back to the activities you enjoy. Then scheduling an evaluation with our sports medicine and movement specialists here in Westerville, OH, will provide you with your customized treatment plan for your tendinopathy.
About Tendinopathy
Common Causes & Common Areas
Tendinopathy is a broad term used to describe pain and changes within a tendon, the strong bands of connective tissue that attach muscles to bones. Tendons help transfer the force your muscles create so you can move, jump, run, lift, grip, and perform everyday activities.
Despite what you may have heard, tendon pain isn't always simply a result of "inflammation." With tendinopathy, the tendon may experience changes in its structure and ability to handle load. Repeated stress can gradually overwhelm the tendon’s ability to recover, causing pain, stiffness, weakness, or reduced performance.
Think of a tendon like a rope that connects a muscle to a bone. When that rope is repeatedly loaded without enough recovery, or when the forces placed on it aren't distributed well, it can become irritated and less capable of handling the demands placed on it. That's why simply resting until the pain disappears doesn't always solve the problem. The goal is to help the tendon become more capable of handling the activities you want to return to.
What Causes Tendinopathy?
Tendinopathy rarely comes from one single event. More often, it develops when the demands placed on a tendon consistently exceed its ability to adapt and recover. Common contributors include:
1. Repetitive Overuse
Running, jumping, throwing, lifting, gripping, or other repetitive activities can place repeated stress on a tendon. Over time, the tissue may struggle to keep up with the demands being placed on it.
2. Sudden Changes in Activity
Increasing your training volume, intensity, or frequency too quickly can overload a tendon that hasn't had time to adapt. This is common when returning to sports, starting a new workout program, or suddenly increasing mileage.
3. Poor Movement Mechanics
How your body moves can influence how force is distributed through your muscles and tendons. Limited mobility, muscle weakness, or inefficient movement patterns can cause certain tissues to take on more stress than they should.
4. Inadequate Recovery
Tendons need time to adapt between periods of significant loading. Insufficient rest, poor sleep, or repeatedly training through pain can make it harder for the tissue to recover.
5. Age & Changes in Tissue Capacity
As we get older, tendons can gradually change in their structure and ability to tolerate load. This doesn't mean tendon problems are inevitable. It simply means that training, recovery, and progressive strengthening become increasingly important.
Where Does Tendinopathy Commonly Occur?
Tendinopathy can affect almost any tendon in the body, but some areas are particularly vulnerable because of the amount of force or repetition they experience.
🦵 Patellar Tendinopathy - Knee
Often called jumper's knee, this affects the tendon connecting the kneecap to the shinbone. It is especially common in athletes who regularly jump, sprint, squat, or change direction.
🦶 Achilles Tendinopathy - Heel & Ankle
The Achilles tendon connects your calf muscles to your heel bone. Running, jumping, and repetitive loading can cause pain and stiffness along the back of the ankle or heel.
💪 Rotator Cuff Tendinopathy - Shoulder
The rotator cuff is a group of muscles and tendons that help stabilize and move your shoulder. Repetitive overhead activity, lifting, throwing, or changes in shoulder mechanics can contribute to tendon pain.
🎾 Tennis & Golfer's Elbow - Elbow
Despite their names, you don't have to play tennis or golf to develop these conditions. Repetitive gripping, lifting, throwing, or wrist movements can overload the tendons on either the outside or inside of the elbow.
The plantar fascia and surrounding tissues help support your foot and absorb forces when you walk, run, or jump. Repetitive loading, changes in activity, or altered foot mechanics can contribute to persistent heel and foot pain.
Common Treatment for Tendinopathy
But Why Pain Keeps Coming Back
NSAIDs, such as Ibuprofen, Naproxen, Aspirin, and Meloxicam, are often the first line of treatment for tendinopathy because it helps reduce the pain. The tradeoff for the relief? Delayed or even completely compromised long-term healing.
Early healing requires a natural inflammatory domino effect to trigger tissue repair. NSAIDs stops a specific enzyme which suppresses the normal tissue remodeling. This often results in structural weakness, particularly where the tendon attaches to the bone.
Direct injections of corticosteroids can drastically reduce pain and swelling! However, the steroid suppresses the cells responsible for producing collagen which decreases the tendon strength. Overtime, this significantly increases the risk of further tendon tearing or full ruptures.
Often, patients are given those one or both of those treatment options for their tendinopathy. Then they're prescribed stretches and exercises or physical therapy which overloads the irritated and weakened muscle and tendon. Without the proper foundation of the tendon and adequate healing, you're unable to beat the cycle of pain, inflammation, and weakness.
Best Treatment for Tendinopathy Pain & Dysfunction
Here at Hughes Health, we break through the stubborn pain using PiezoWave Focused Shockwave Therapy. Shockwave Therapy uses focused and targeted sound waves to:
Break up scar tissue and adhesions
Increase blood flow for faster healing
Stimulate natural tissue repair without surgery or downtime
Our shockwave treatment typically takes 5 minutes per session and is usually recommended 2-3 times per week for up to 6 weeks, depending on how long you've been dealing with tendinopathy and how often it keeps coming back.
Studies have shown shockwave therapy performed alone has resulted in 76-95% improvement without the combination of other therapy. Here's how:
Shockwave therapy has been shown to promote new collagen production, which can lead to stronger tissues and faster healing times. Collagen is the key protein in the healing of connective tissue. It is responsible for providing strength and support to injured tissues as they heal. When an injury occurs, collagen production increases to repair and replace damaged tissue. This process is essential for proper healing and helps to prevent further damage. When this healing stops, shockwave intervenes.
Shockwave therapy can help to break down and dissolve minor calcified tissue, which is what often builds up and causes pain. The dissolved calcified tissue will be cleared away by the lymphatic system.
Shockwave therapy can stimulate blood flow and promote healing by helping to deliver nutrients and oxygen to the affected area. In addition, it stimulates the creation of new blood vessels, which also boosts blood flow. All in all, both are essential in creating the perfect environment for healing to take place.
Shockwave therapy can help reduce inflammation, swelling, and pain by decreasing the release of inflammatory mediators from cells in the treated area. The sound waves cause tiny vibrations in the tissue, which help to break up the inflammatory cells and promote healing.
Finally, shockwave therapy is completely non-invasive and relatively safe when compared with other treatment options, such as surgery or injections, as even minimally invasive techniques carry the risk of complications. The risks associated with this treatment are minimal and most often temporary. As such, it is recommended for a lot of patients, especially those who don’t want to deal with side effects or risks as a result of surgery or injections.
Other Treatments for Tendinopathy
Find Relief Once & For All For Your Tendinopathy Pain in Westerville, OH
Before we are able to treat your tendinopathy and related pain at Hughes Health, we must perform a detailed consultation and examination. We start with a one-on-one consultation where our doctors truly listen. We want to understand how your neck or back pain is affecting your life, whether it's keeping you from working, exercising, or simply enjoying time with family. This conversation helps us gather key details that point us toward the root cause of your pain.
In the examination, we assess your movement, muscles, ligaments, and joints using orthopedic and functional movement testing, typically used at the elite and professional athletic level. Pain is your body’s way of signaling that something isn’t working right. Our job is to find out why and help you understand. Once we pinpoint the cause, we create a personalized treatment plan to restore function and get you back to living pain-free without unnecessary medications or surgery.
While PiezoWave Focused Shockwave Therapy is the best treatment for tendinopathy, we also combine it with other therapies to work on the structure of the tendon, the swelling and irritation around the tendon, and THEN the strength and elasticity of the tendon. This comprehensive approach is what sets us apart from other sports medicine specialists and what helps you from recurring tendinopathy and pain.
Deep Tissue Class IV Laser Therapy: Heal from the Inside Out
Our Class IV Deep Tissue Laser uses light therapy to reduce pain and inflammation at the cellular level. This advanced treatment:
Boosts your body’s natural healing process
Reduces pain and inflammation in just 5-10 minutes
Feels like a gentle, warming sensation with no discomfort
Spinal Decompression: Relieve Pressure, Restore Function
If you’re struggling with a herniated or bulging disc that has led to tendinopathy pain, Spinal Decompression Therapy provides a gentle, sustained stretch to:
Reduce pressure on your spine, nerves, and tendons in the neck or back
Guide discs back into proper position
Work alongside other regenerative care and corrective exercises to help you heal and prevent future injuries
Sports Chiropractic: More Than Just Adjustments
At Hughes Health, we believe true recovery goes beyond spinal adjustments and manipulation. While we are chiropractors, we don’t just focus on your joints. We take a whole-body approach through Sports Rehabilitation to target the muscles and tissues that support you and your joints. Your body is more than just bones and joints, and your care should reflect that too. By addressing movement, strength, and stability, we help you heal faster, stay active, and prevent future injuries so you can get back to doing what you love without limitations.
Soft Tissue Manual Therapy: Digging Deep
At Hughes Health, we specialize in a wide variety of techniques to address the soft tissue causes of the pain.
Dry Needling: This targets tight or dysfunctional muscles by inserting small acupuncture needles into specific muscles and their trigger points to release tension and promote muscle recovery.
Fire Cupping: Using heated cups to create a suction effect on the skin helps increase blood flow to relieve muscle tightness and reduce pain. This warming effect has been shown to be more effective than the dry suction counterpart.
Graston Technique: Using specialized tools, we gently break up adhesions in your muscles and tendons, improving mobility and encouraging proper tissue healing.
Myofascial Release: Active Release Technique (ART), also known as manual trigger point release, takes your muscles through dynamic movement to release tension and alleviate pain at its source.
Sport Rehab and Custom Exercises: Build Strength, Prevent Injury
Pain relief is just the first step. Staying pain-free while moving and grooving is the goal. Our Custom Therapeutic Exercise Programs help you:
Strengthen muscles and improve mobility
Fix imbalances that cause recurring pain
Get back to doing what you love with confidence
The Right Care, Every Time: Adaptable for You
At Hughes Health, your recovery comes first. While we specialize in non-invasive, non-surgical sports medicine and movement dysfunctions, we also know when you need more. If our exam reveals that additional care is necessary, we’ll connect you with our trusted network of physical therapists, orthopedic surgeons, neurosurgeons, and pain specialists. No guesswork, no wasted time! The right plan for the best results is a click away.
Your health is our priority. Let’s get you on the path to recovery today!
Why Choose
Hughes Health?
We take pride in providing evidence-based non-invasive approaches to healthcare. Our goal is to identify the root cause of your discomfort and pain to then provide effective and personalized treatment plans to help you achieve long-lasting results. If you're experiencing any of the conditions listed above, don't hesitate to contact us.