Tendinitis or Tendinosis? Golfer’s Elbow or Tennis Elbow?
These are questions that I get asked frequently, I hope to shed some light on the terminology and help folks understand the difference if pain strikes. The diagram provided will assist in determining the exact pain location areas and type of injury.
Here’s an easy way to remember the difference for Golfer’s Elbow, it is on the inside of the elbow where the skin is usually hairless and smooth like a golf ball and Tennis Elbow is on the outside of the elbow where the skin usually has hair and furry like a tennis ball.
Most people who think they have tendinitis actually have tendinosis. The difference is not just one of semantics; it’s an issue of understanding. You can’t have chronic tendinitis. If it’s chronic, it’s probably tendinosis.
In tendinosis the tendon goes through a structural soft tissue change in response to the chronic stress and repetitive motion movements and the soft tissue becomes compromised.
Tendinosis is different, and the treatment is different. Ice and anti-inflammatories do little for tendinosis, as the condition is no longer an inflammatory one. To rehab a tendinosis condition, it may be necessary to endure some tendon pain to produce the reconstruction effect in the soft tissue.
If there’s no soreness during a tendon rehab program, research shows reps or external weight should increase. This is an isolated exception to the “No Pain Rule” (if you feel pain during an exercise stop immediately). The painful stress to the tendon acts much like soft tissue work to initiate a healing process.
In conclusion acceptable pain is localized to the target tissue, and the tissue is painful to the touch. There should be no swelling and no motion restrictions. The pain should follow a delayed onset muscle soreness pattern and be gone in two or three days.