Tendinitis

Tendinitis is the everyday name for tendon pain from overload, though tendinopathy is the more accurate term: biopsy studies show collagen disorganisation and degeneration rather than the classic inflammation the -itis ending implies. It typically follows a rise in load - a new training programme, a return after a break, or repeated occupational strain - and affects the Achilles, patellar, rotator cuff, elbow and gluteal tendons most often. Pain is characteristically worse at the start of activity, may ease as it warms up, and returns worse the following morning. That 24-hour response is the most useful guide to whether load is appropriate. Because the tissue problem is degenerative rather than inflammatory, the treatments that work are the ones that stimulate tendon remodelling: progressive loading, including isometric holds for pain relief and heavy slow resistance or eccentric work for structural adaptation, over 12 weeks or more. Prolonged rest weakens the tendon and delays recovery; corticosteroid injections give short-term relief but worse outcomes at 12 months in several trials. Supplement evidence is limited and adjunctive at best: collagen peptides at 15 g/day with 50 mg vitamin C taken an hour before loading has preliminary support for collagen synthesis, and omega-3 fats may help pain modestly.