Tendinitis vs. Tendinosis: What’s the Difference?

If you’ve ever had nagging elbow pain after a long weekend of yard work, or your Achilles tendon screaming at you after ramping up your mileage too quickly, you may have heard the term “tendinitis” tossed around. It’s the go-to explanation for tendon pain—but here’s the plot twist: not all tendon pain is actually tendinitis. Sometimes, it’s tendinosis.


While the names sound almost identical, these conditions are very different. Understanding which one you’re dealing with is key to proper treatment, preventing reinjury, and speeding up recovery. Let’s break it down in a way that makes sense (no medical degree required).

First Things First: What’s a Tendon?

Tendons are the strong, fibrous cords that connect muscle to bone. They act as transmitters, helping muscles generate the force needed for movement. Imagine them like high-strength climbing ropes—flexible, durable, and capable of withstanding a lot of tension.


But even ropes have their limits. Put too much stress on a tendon too quickly, or repeat the same motion over and over without enough rest, and you can end up with microscopic damage. If your body doesn’t get a chance to repair that damage, pain and dysfunction soon follow.

Tendinitis: The “Hot” Injury

The suffix “-itis” means inflammation, and that’s exactly what tendinitis is: inflammation of a tendon. This is the body’s short-term alarm system. When you overdo it—say you spend hours weeding your garden when you’re usually behind a desk—the tendon fibers get irritated, and your body rushes in with an inflammatory response.

Symptoms of Tendinitis:

  • Sharp, localized pain during movement
  • Swelling or mild puffiness
  • Warmth or redness around the tendon
  • Pain that’s usually worse with activity, but may ease with rest

Tendinitis is an acute injury, meaning it tends to show up suddenly and intensely. The good news? With the right care, it usually improves within a few weeks.

Treatment for Tendinitis

Because tendinitis is an inflammatory condition, treatment focuses on calming things down:

  • Rest and activity modification – Give the tendon a break from the activity that triggered the flare-up.
  • Ice – Helps reduce swelling and discomfort.
  • Gentle stretching – Keeps the area from stiffening up.
  • Massage therapy – Improves blood flow and reduces surrounding muscle tension.
  • Chiropractic care – Restores proper joint alignment to minimize mechanical stress on the tendon.

Tendinosis: The “Stubborn” Injury

Now, here’s where things get tricky. If tendon pain lingers for months instead of weeks, you may not be dealing with inflammation anymore. Instead, the tendon itself has started to break down. This is tendinosis.


Tendinosis is a degenerative condition, meaning the tendon fibers are wearing down over time due to repetitive stress and inadequate healing. Unlike tendinitis, there’s no active inflammation—just a tendon that’s become structurally weaker.

Symptoms of Tendinosis:

  • A dull, aching pain that builds gradually
  • Stiffness, especially in the morning or after rest
  • Pain that may persist even after activity stops
  • Tenderness when pressing on the tendon
  • Thickening or a “lumpy” feel in the tendon

Tendinosis is more frustrating because it doesn’t resolve with just a few weeks of rest. The tendon needs active rehabilitation to encourage new, healthy tissue to replace the damaged fibers.

Treatment for Tendinosis

Because the issue is degeneration rather than inflammation, treatment looks different:

  • Eccentric strengthening exercises – Slowly lengthening the muscle under load (think heel drops for Achilles tendinosis) stimulates tendon remodeling.
  • Soft tissue therapy – Techniques like massage or instrument-assisted mobilization help increase blood flow.
  • Chiropractic adjustments – Improve biomechanics to reduce abnormal stress on the tendon.
  • Nutritional support – Collagen and vitamin C can assist tissue healing.
  • Gradual loading – A carefully structured return-to-activity program helps build tendon resilience.

Why the Difference Matters

This is where many people go wrong. Tendinitis and tendinosis both cause tendon pain, but they require different management strategies.

  • Treating tendinosis like tendinitis(resting, icing, and waiting it out) won’t solve the problem—it may even make it worse by allowing further degeneration.
  • Treating tendinitis like tendinosis(jumping into aggressive exercise too soon) can prolong the inflammation and increase pain.

That’s why getting the right diagnosis matters. The right treatment depends on whether your tendon is inflamed (tendinitis) or breaking down (tendinosis).

Common Areas Where Tendon Trouble Strikes

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  • Elbow – “Tennis elbow” (lateral epicondylitis/tendinosis) and “golfer’s elbow” (medial epicondylitis).
  • Shoulder – Rotator cuff tendons are frequent victims of overuse.
  • Achilles tendon – Often stressed in runners, jumpers, and anyone upping their activity suddenly.
  • Knee – Patellar tendon pain, sometimes called “jumper’s knee.”
  • Wrist – Common in desk workers, athletes, and anyone doing repetitive gripping.

Where Chiropractic and Massage Come In

Chiropractic care and massage therapy are powerful partners when it comes to managing tendon injuries. Here’s how:

  • Chiropractic care helps by addressing underlying joint and movement dysfunctions. If your ankle doesn’t move properly, your Achilles tendon takes the brunt. If your shoulder mechanics are off, your rotator cuff pays the price. Correcting these issues helps unload the tendon and reduce the risk of reinjury.
  • Massage therapy boosts circulation, improves flexibility, and decreases muscle tension around the tendon. This can speed up healing, especially in tendinosis cases where blood flow is often limited.

Together, these approaches not only treat the pain but also target the “why” behind it—so you can get back to your favorite activities with fewer setbacks.

How to Protect Your Tendons

Prevention is always better than rehab. Here are a few tendon-friendly habits:

  1. Warm up properly before activity to prepare muscles and tendons.
  2. Increase intensity gradually —avoid sudden spikes in exercise volume.
  3. Cross-train to prevent overloading the same tendon day after day.
  4. Strength train —especially eccentric exercises—to keep tendons strong.
  5. Listen to your body —don’t push through sharp tendon pain.

The Bottom Line

Tendon pain isn’t one-size-fits-all.

  • Tendinitis= inflammation (short-term, “hot” injury).
  • Tendinosis= degeneration (long-term, “stubborn” injury).

Knowing the difference makes all the difference for recovery. If your tendon pain has hung around longer than a couple of weeks, it may be more than just “tendinitis.”


Don’t play the guessing game. A chiropractor or massage therapist can help determine what’s really going on and create a personalized plan to get you back to moving comfortably.


So whether it’s your elbow, shoulder, knee, or Achilles that’s giving you grief, let us help you untangle tendon trouble—before it ties you in knots.

Bethany Wolcott

D’Youville Chiropractic ‘26

By S21 GMB February 17, 2026
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Fiber comes in two main forms: Soluble Fiber Dissolves in water and forms a gel-like substance Helps slow digestion Supports blood sugar control and cholesterol levels Found in foods like oats, beans, apples, citrus fruits, chia seeds, and flaxseed Insoluble Fiber Does not dissolve in water Adds bulk to stool and helps move things along Supports regular bowel movements Found in whole grains, nuts, seeds, and many vegetables (especially skins) Most fiber-rich foods contain a mix of both types, which is great—your body benefits from each in different ways. What Does Fiber Do in the Body? Fiber’s most famous job is keeping digestion regular, but that’s just the beginning. 1. Supports Digestive Health Fiber helps: Prevent constipation Improve stool consistency Feed beneficial gut bacteria A well-fed gut microbiome produces short-chain fatty acids that help regulate inflammation, immune function, and gut integrity. Translation: fiber helps your gut work with you, not against you. 2. Helps Regulate Blood Sugar Soluble fiber slows the absorption of sugar into the bloodstream, which helps prevent sharp spikes and crashes in blood glucose. This is especially important for people managing insulin resistance, prediabetes, or energy slumps throughout the day. 3. Supports Heart Health Fiber—particularly soluble fiber—can help lower LDL (“bad”) cholesterol by binding to cholesterol particles in the digestive tract and escorting them out of the body. Lower cholesterol levels are associated with reduced cardiovascular risk. 4. Aids in Weight Management Fiber increases feelings of fullness and satiety, which can help reduce overall calorie intake without intentional restriction. High-fiber foods also tend to require more chewing and take longer to digest—giving your brain time to register that you’re full. 5. Helps Manage Inflammation Chronic, low-grade inflammation plays a role in joint pain, stiffness, and many musculoskeletal conditions. Fiber supports a healthier gut environment, which is closely tied to systemic inflammation levels. A calmer gut can mean a calmer body. Why Fiber Matters for Chiropractic and Massage Patients So what does fiber have to do with your spine, joints, and muscles? More than you might think. Reduced inflammation can support joint comfort and tissue recovery Improved nutrient absorption helps your body better utilize vitamins and minerals needed for muscle and connective tissue health Better gut health can influence pain perception and nervous system regulation If your body is inflamed, under-fueled, or struggling with digestion, it can absolutely affect how you feel physically—and how well you respond to hands-on care like chiropractic adjustments or massage therapy. How Much Fiber Do You Need? General daily recommendations: Women: ~25 grams per day Men: ~38 grams per day Most people average closer to 10–15 grams daily, which means there’s a big opportunity for improvement. 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If you’re considering a supplement, it’s best to discuss it with a healthcare provider—especially if you have digestive conditions or are managing blood sugar or cholesterol levels. Tips for Increasing Fiber Without Upsetting Your Gut Increase intake slowly over 1–2 weeks Drink more water as fiber intake rises Spread fiber across meals instead of loading it all at once Mix raw and cooked vegetables Pay attention to how your body responds Some temporary gas or bloating can happen at first—this usually settles as your gut adapts. The Bottom Line Fiber may not be flashy, but it’s foundational. It supports digestion, heart health, blood sugar balance, inflammation control, and even how your body feels day to day. For patients receiving chiropractic or massage care, optimizing fiber intake can be one more way to support overall comfort, recovery, and long-term wellness.  If you’re curious about how nutrition, movement, and hands-on care can work together to help you feel your best, talk with one of our providers at your next visit. Sometimes small changes—like adding more fiber—can make a surprisingly big difference. Your gut (and your spine) will thank you. Bethany Wolcott D’Youville Chiropractic ‘26
By S21 GMB February 9, 2026
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A helpful way to think about it: if your spine has been feeling “compressed” by life, decompression therapy gives it room to breathe again. What It’s Like to Use the Back-on-Trac Chair One of the reasons patients love the Back-on-Trac is how comfortable and approachable it feels. You’re seated upright in a supportive chair, secured with straps to ensure proper positioning. Once the session begins, the chair applies a gentle traction force tailored to your body and condition. There’s no sudden pulling, twisting, or cracking. Most people describe the sensation as a deep, relieving stretch—often followed by a feeling of lightness or relaxation. Many patients are surprised by how calming the experience is, especially if they came in expecting something intense. Sessions are typically short, making it easy to fit into your day, and there’s no downtime afterward. You can return to work, errands, or other treatments feeling looser and more comfortable. Who Can Benefit from Back-on-Trac Decompression? Decompression therapy is especially helpful for people whose pain is rooted in disc or nerve compression. Some common conditions we see improvement with include: Herniated or Bulging Discs When discs push outward and irritate nearby nerves, pain can radiate into the arms or legs. Decompression can help reduce that pressure, easing symptoms like sharp pain, tingling, or numbness. Sciatica Pain that travels from the lower back into the hip or leg is often caused by compression of the sciatic nerve. By relieving spinal pressure, decompression therapy may help calm irritated nerves and reduce radiating pain. Degenerative Disc Changes As discs naturally lose hydration with age, the spine can become stiff and painful. Decompression helps offload stressed discs and supports healthier movement patterns. Spinal Stenosis Narrowing of the spinal canal can compress nerves and cause discomfort or weakness. 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Think of the Back-on-Trac as part of a bigger picture—one tool in a comprehensive approach to caring for your spine. Why an Initial Chiropractic Visit Matters Before hopping into the Back-on-Trac chair, we always start with an appointment with one of our chiropractors. This step is essential. Not every condition is appropriate for decompression, and we want to make sure it’s both safe and effective for you. During your initial visit, your chiropractor will review your health history, assess your spine, and determine whether decompression therapy fits into your personalized care plan. Once you’re cleared, you can schedule Back-on-Trac sessions with confidence, knowing your care is tailored to your body’s needs. We currently offer Back-on-Trac at both of our locations, making it easy to access this popular therapy. Is the Back-on-Trac Right for You? If you’ve been living with back or neck pain, feeling stiff when you wake up, or noticing that everyday activities are becoming less comfortable, decompression therapy may be worth exploring. The Back-on-Trac chair is gentle, effective, and designed to support healing—not just mask symptoms. Sometimes, the most powerful changes come from giving your body the space it needs. Ready to Try “The Chair”? The Back-on-Trac Decompression Chair has helped countless patients find relief, improve mobility, and feel more at ease in their bodies. If you’re curious about whether it’s right for you, we’d love to help. Schedule your initial chiropractic appointment today, and take the first step toward a spine that feels supported, decompressed, and ready for whatever life throws your way. Bethany Wolcott D’Youville Chiropractic ‘26
By S21 GMB February 2, 2026
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