Overuse tendinosis, not tendinitis, part 1: a new paradigm for a difficult clinical problem (part 1)
Nine pages on PainSci cite Khan 2000: 1. Deep Friction Massage Therapy for Tendinitis 2. Icing for Injuries, Tendinitis, and Inflammation 3. The Complete Guide to IT Band Syndrome 4. The Complete Guide to Patellofemoral Pain Syndrome 5. Complete Guide to Plantar Fasciitis 6. Tennis Elbow Guide 7. Does Arnica Gel Work for Pain? 8. Pseudo-Quackery in Physical Therapy 9. Guide to Repetitive Strain Injuries
PainSci notes on Khan 2000:
From the abstract: “If physicians acknowledge that overuse tendinopathies are due to tendinosis, as distinct from tendinitis, they must modify patient management … ”
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Overuse tendinopathies are common in primary care. Numerous investigators worldwide have shown that the pathology underlying these conditions is tendinosis or collagen degeneration. This applies equally in the Achilles, patellar, medial and lateral elbow, and rotator cuff tendons. If physicians acknowledge that overuse tendinopathies are due to tendinosis, as distinct from tendinitis, they must modify patient management in at least eight areas. These include adaptation of advice given when counseling, interaction with the physical therapist and athletic trainer, interpretation of imaging, choice of conservative management, and consideration of whether surgery is an option.
related content
- “Overuse tendinosis, not tendinitis, part 2: applying the new approach to patellar tendinopathy,” Cook et al, Phys Sportsmed, 2000.
- “Histopathology of common tendinopathies. Update and implications for clinical management,” Khan et al, Sports Medicine, 1999.
- “Plantar fasciitis: a degenerative process (fasciosis) without inflammation,” Lemont et al, Journal of the American Podiatric Medical Association, 2003.
- “Treatment of tendinopathy: what works, what does not, and what is on the horizon,” Andres et al, Clinical Orthopaedics & Related Research, 2008.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Restoring trust in menopause management: menopause hormone therapy is not a panacea, and physical activity remains a critical intervention. Tulloh 2025 Br J Sports Med.
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.