Tendonitis vs. Tendinosis (what they mean and how to treat them)

Understanding the difference between these two issues is key to correctly treating them.
While these 2 terms are used interchangebly by a lot of people, they're actually quite different.
In this video, I'll explain the key differences between tendinitis and tendinosis. And I'll also go into how knowing what you're dealing with will dictate your treatment plan.
I'll also give a couple quick examples of shoulder/rotator cuff pain and Achilles pain.
If you have any questions about rotator cuff or Achilles tendon pain, please leave a comment below. Thanks for watching!
- Luke Gordon, DPT
Owner of Gordon Physical Therapy
www.gordonphysicaltherapy.com/

[@rredfnhgswsabbsnsvns]

Mate you’re an inspiration, no one on the internet has explained the difference between tendinosis and tendinitis like you did. Keep up the great work, we the humans of this earth appreciate your hard work and the help you’re providing 🙏🙌

[@GordonPhysicalTherapy]

I appreciate that! Thank you very much for your kind words :-)

[@fairness668]

Thank you, Luke. I never learned as easy as I did with this explanation.

[@GordonPhysicalTherapy]

You're very welcome!

[@monyabARTon]

Thanks for your reaching us that need to understand our situation instead of just thrown to the wind for help!

[@GordonPhysicalTherapy]

You're welcome!

[@peakphysiotherapyperformance]

This is such a good breakdown! Thanks for the great content!

[@GordonPhysicalTherapy]

You're quite welcome! Thank you for watching!

[@johnd4270]

Thanks so much I've had my knee for years and I never really realize with tendinosis was until I listen to you

[@GordonPhysicalTherapy]

Glad it helped!

[@PeeBeeJellyfish]

Really good info, I feel like I learned a great deal on the difference.

[@GordonPhysicalTherapy]

Thank you, sir! - Luke Gordon

[@saqibnawaz5139]

An amazing nd very informative video to narrow down the both confusing conditions

[@GordonPhysicalTherapy]

Thanks, Saqib!

[@pilatesaustintexas512]

I really love the explanation you provide. Thanks.

[@GordonPhysicalTherapy]

Thanks for the comment! You're most welcome :-)

[@pilatesforptspodcastbusine287]

This is excellent information that is very consumable for anyone... Thanks

[@GordonPhysicalTherapy]

Thank you! Glad you liked the video :-)

[@ThePittsburghChiropractor]

Solid break down Dr.Gordon!

[@GordonPhysicalTherapy]

Thank you, Dr. Tauberg! I appreciate it :-)

[@alfredregan4562]

Hey Luke, I just want to say first off out of all my research online for my injury, this video has been the most clear and you have spoken so eloquently on this matter. I have been injured on my adductor for the past year accumulating 3 small muscle rips that have healed but because I played on them throughout the last year have led to edema on the tendons that attach my adductors to my pelvic bone. I have seen two physical therapists so far and my pain hasn't really changed in last 2 months since MRI and ultra sound. My coaches and therapist are telling me to continue running and doing light training everyday for my tendinosis injury, whenever I do light running I don't feel pain but as soon as I do harder running or incorporate bi lateral movements I feel pain in adductor or lower abdomen surrounding my edema. My question I have for you is whether I should be pushing through exercise where I feel pain during or after? Should be doing exercise but not that I feel pain during or after? Or whether I Should just be resting and exercise is just making it worse? Therapists and doctors have all told me different things so Im unsure.

[@deepikaaggarwal5124]

This was literally a clear explanation I am really thankful to you Blessings to you

[@GordonPhysicalTherapy]

You're welcome!

[@ashuraya2779]

Great information about the tendon problems. I probably have Tendinosis and must fix it. Thank you sir!

[@GordonPhysicalTherapy]

I hope it helps! Thank you for watching :-)

[@amitsharma-ms7hw]

hello Ashuraya, did you fix your supraspinatus tendinosis ?

[@noumanriaz8140]

Thank you for explaining in a good way. I am having popliteal tendinosis.can you kindly explain peognosis and treatment options. Thanking you in anticipation.

[@recalcitrantdefiance]

Thank you for this!! It is a big help.

[@GordonPhysicalTherapy]

You're welcome! Thanks for watching :-)

[@UTAH100]

Excellent explanation. So if it's been a month+ now (shoulder) I'm guessing it's tendinosis. It is not acute and only certain movements bother it. Should use a little warm heat, stretching and strength? QUESTION: Should I venture into the specific areas (stretches) that bother it to work it out- or avoid those sensitive areas during my DIY PT? Based on this, I think you want blood flow so maybe lean into the pain within reason and see how it goes? "The McKenzie Method" is big on this approach with back issues- visualize the pain moving then going away. Not sure if it's the same for rehabbing the shoulder. Based on your other video, I did NOT guard my shoulder today. I walked the dog using it and it felt GOOD! I didn't realize, if you don't use it, you lose it. Within reason, I am going to try to use it more and keep that healing blood flowing! I am also eating Tumeric w/Black Pepper and Vit. D and Magnesium. THANK YOU!

[@qxezwcs]

This is awesome content. I learned alot about tendinosis. I’ve experienced it before in my forearm and no amount of medication worked. The doctor told me that it may require surgery but I was very hesitant to go under the knife so I checked other options. Turned out the bamboo thing is what solved my problem where the therapist repeatedly hit the part of my forearm with a controlled strength and warm compress at home next session after a few days was deep massage (damn painful I was literally howling)... they switch it a couple of sessions and after a while it was good. No surgery was done.

[@GordonPhysicalTherapy]

Thank you, LECRON! And nice work avoiding surgery but seeking other options!

[@paintedoak1]

Hey there, I'm suffering hugely from elbow/forearm tendonosis. Can you explain what worked in more detail? I'm 4 months in and not improving.

[@alexpeternel6498]

Same here, 1.5years in, 50 PT visits, countless medication. Doing strengthening workouts at home, but it's still persistent and it won't go away

[@friekek9683]

this was very informative - I definitely seem to have tendinosis around the hips and nobody I saw seems to know what to do about it.....

[@GordonPhysicalTherapy]

Glad it helped! Hip bursitis is often actually tendinosis of the gluteus medius tendon as it attaches to the outside hip bone (the greater trochanter). A good PT should be able to help you with that :-)

[@friekek9683]

@@GordonPhysicalTherapy Austrians seem to be trained to deal with hip op patients...but you confirm what I think.....

[@harolddasynth795]

This is what i am looking for,thanks Gordon for the explanation,i thought they are the same...

[@GordonPhysicalTherapy]

You're welcome!

[@thomasromeni8063]

Hello, Josh. I have a bilateral gluteus Medius tendinopathy. If Eccentric exercises were the right for the Gluteus Medius muscles and should generally be pain-free during the execution and only the pain is decisive after 24 hours or would a certain pain be tolerable even during the exercises? Greetings from Germany, Thomas.

[@jameshoskins2988]

Hey Luke, Awesome content. I was diagnosed with mild infraspinatus tendonosis about two months ago and it has been very frustrating. I was wondering if it is possible (with time) to have a full recovery from this condition. I have read eccentric loading seems to help in restructuring the tendon and perhaps even causing inflammation to signal to your body this tendon needs to be healed , as you’ve mentioned in this video. Thanks again and it’s very comforting to be able to get some answers.

[@GordonPhysicalTherapy]

Hi, James. I'm glad you found the video helpful! Everyone's a little different, but in general I'd say YES you should be able to make a full recovery. Rotator cuff issues in general can be very frustrating and slow to heal, which is why these issues are so common. Eccentric loading can be very helpful. Like you mentioned, it can instigate the inflammatory process, which is necessary for tissue healing. The trick of course is not to cause TOO much inflammation, as that will make the pain worse. Here's what I'd recommend: if you're not getting the results you're looking for after 4-6 weeks, reach out to a good PT in your area for some help. If you need any help finding a PT in your area, or you'd like to consider working with one of ours via telehealth, just shoot me an email at [e-mail] and I'll be happy to help you out! And if you have any more questions, fire away!

[@iantincangleed4702]

Great film mate cheers

[@GordonPhysicalTherapy]

Thank you! I appreciate that! Cheers :-)

[@kathiamata6905]

Hello, first of all I loved the explanation, very nice and clear. Almost two years ago I started with pain in my elbows, it was worse in the mornings, I completely ignored it, I was crocheting a lot back then and I think that was what caused this, eventually the pain was so bad that I went to a PT and started therapy, icing and anti inflammatory meds which I hate because they hurt my stomach, life got in the way and I stopped therapy, now it's been almost two years, the pain it's permanent, and absolutely horrible, I had to get rid of all my ceramic plates and bowls and get light weight plastic ones, it hurts to do dishes, to brush my teeth, to exercise, I'm a little overweight so I just started diet and I'm trying to change my life, cutting out all the bad foods, but I really need help with my problem, it's clearly tendonosis, I just need to know what's the next step, I would like to avoid surgery if possible and I would love to be able to crochet again, something I stopped doing when I stared therapy, I keep icing because it helps with the pain and I use straps and sleeves. Please help🥺

[@GordonPhysicalTherapy]

Hi, Kathia. I would recommend working with a PT again, especially one who does hands-on treatments. My basic approach to treating tendinosis is to use things like heat, friction massage and eccentric strengthening to encourage tissue healing. This involves inflaming the tissue, which is a delicate balance. Do you have a good PT you can work with?

[@abhianand8229]

Hey luke Thanks for this amazing content. I am diagnosed with mild tendinosis in the distal fibres of supraspinatus. Can u please suggest recovery exercises. Thanks

[@GordonPhysicalTherapy]

Happy to help, Abhi! I'd recommend some pain-free rotator cuff exercises to get started. I have some videos on these exercises. Let me know if you need help finding them :-)

[@nunaoooo]

I have tendinosis on my elbow for about 5 months now from overloading the triceps in the gym. I’m looking for a treatment but I only find tennis or golf elbow videos. My pain is at the very tip of my elbows, and only hurts when I lean or touch them. What should I do?

[@z1337zGC]

Amazing video

[@nickadamany8687]

I have a quad tendon problem that I’ve been dealing with for the last 7 months I wait 5-14 days and i feel good when I jog and even run but when I want to go 100 percent i begin to feel pain and my knee slowly loses motion I try to elevation,compression, icey hot and every time I think I’m ready to come back and I am not

[@Doctor-Stoppage]

I was diagnosed with tendonosis in my left shoulder almost 4 years ago (from repetitive heavy manual labor for years.) I tried doing physiotherapy about 3 years ago but it made the pain worsen. I've tried a couple of massages that made the pain worsen. Now my shoulders feel like they're at different positions and the bad one feels like it's just hanging there sometimes.

[@GordonPhysicalTherapy]

I'm sorry to hear about your ongoing shoulder issues... shoulder pain in general can be really difficult to get rid of, especially with tendinosis issues. I have some other videos on the topic that might be helpful for you. Try this one for now, and then let me know if you have any specific questions (it's about why REST doesn't help, and what you should do instead): kzbin.info/www/bejne/qZDQimOmhNySi5o Good luck!

[@amitsharma-ms7hw]

hello did you recover from supraspinatus tendinosis ?

[@ehsstriker]

Have you found relief yet? Wife has tendonosis and is in the same boat, pt made it worse, and massage made it worse

[@sovereigncitizen3633]

Back in October 2015 I injured my rotator cuff lifting weights. I love to train boxing and martial arts and the months following the initial tendinitis I re-aggravated the injury several times. I finally got an MRI in February 2016 which revealed tendinosis of my supraspinatus and infraspinatus tendons. I was depressed and discouraged for awhile and struggling with the physical therapy. I finally got a good schedule and made some good progress in May and June of 2016. However, it was still not fully recovered. I finally started doing push-ups and weight resistant cable machine shoulder exercises and noticed that while the exercises hurt and the inflammation would flare up it would eventually start feeling better within a week; and the recovery time would decrease after each workout. Each workout would be a bit less painful as well. I think that this was the case because I was breaking up the scar tissue of the tendinosis in a healthy way. What do you think? Is it okay to feel that type of pain during recovery?

[@GordonPhysicalTherapy]

Hi, Zach! I apologize for the last response...you posted this question 10 months ago and I totally missed it. So I'll answer your question, and I hope it's still helpful. Although to be honest, I'm hoping you're 100% better, and this reply won't even matter! So here you go: I agree with your impression that you were probably breaking up a little scar tissue and encouraging some inflammation. As you applied your training method consistently over time, you were inflaming the tendons, then allowing them to heal, and you must've found a good balance for your tissue to heal. In terms of how much pain is okay to feel during a training session, I would still try to keep it low. You want to make those rotator cuff muscles burn a bit by working low resistance and high reps at first, but hopefully that muscle burn/fatigue doesn't cross into pain too much. I hope that all makes sense, Zach. Let me know if you have any more questions for me, and sorry again for taking so long!

[@pashtun-travels-uk]

That's gr88.. I had a ruptured tendon right side shoulder during workout about 2 years ago..I heard a pop sound which felt like its ruptured.. the MRI shows its little damaged but not ruptured..though it's still aches and even my right side leg and hand fingers also ache when I stress some force on them.. I don't understand what's the real problem!!

[@crystalsmultifaceted]

Go to years ago I got tendinitis in my wrist from indoor rock climbing. I went to a physical therapist and was given exercises which improve things, however I kept re-injuring it until I could do almost nothing. Since then I haven't been able to even do the original exercises I was given. I am getting very frustrated with the lack of progress and the Kaiser doctors I have seen so far don't seem to know what to do.

[@GordonPhysicalTherapy]

Hi, Crystal. If all your previous PT gave you was exercises, I'd recommend seeing a different one who will focus on hands-on therapy. Whether you have tendonitis or tendinosis, the hands-on treatment will help you get through the pain and inflammation. From there, you can focus on your flexibility and strength, but you have to get on top of your pain first. I hope that helps! - Luke Gordon

[@JJ33438]

Thank you so much.

[@GordonPhysicalTherapy]

You're welcome!

[@hrgrant]

Thank you for the explanation. I have another related term I am looking to clarify and compare / contrast with tendonitis and tendinosis. It is - from an ultrasound ." The supraspinatus shows thickening and heterogeneity consistent with tendinopathy." . I googled tendinopathy and got a definition, but not that helpful. thanks!!!

[@GordonPhysicalTherapy]

Tendinopathy is a more general term for issues related to your tendon. More than likely, they're actually referring to tendinosis, which is a little more specific.

[@jimsolmer1292]

Can shoulder tendinosis be totally reversed? Can a biceps tendon with high grade tendinosis go all the way back to normal? My PT said yes and also that the "small perforated tear" will also fully heal but I really find it hard to believe.

[@ontiverosalexx]

Just found this video and I found it really helpful. I unfortunately have had should pain for about 3 years, I’m not even sure at what point I caused the injury. It might have been when I was doing a lot of over head lifting but I didn’t really think anything of it. I recently finally got around to doing an MRI and it says “mild supraspinatus tendinopathy without tear. Normal infraspinatus, teres minor and subscapularis tendons without a tear”. I haven’t been able to work out like I used to and the pain is constantly there. Any suggestions ? Physical therapy, deep tissue massage?

[@GordonPhysicalTherapy]

For supraspinatus "tendinopathy" I would recommend comfortable rotator cuff strengthening, possibly eccentric strengthening if it doesn't increase your pain. If it's feasible, I'd also recommending working with a PT in your area, just to make sure you don't overlook any other contributing factors to your pain. I hope that helps! - Luke Gordon

[@seanwilliams5403]

Thank you!

[@GordonPhysicalTherapy]

You're welcome!

[@yeeyeed1121]

Great video .. thanks so much. I had a rotator cuff tear appearing on an MRI two yrs ago. Physical therapy for two yrs helped a bit, but still experienced pain sometimes even difficult getting dressed or undressed. About two months ago, unfortunately got into a pedestrian accident struck by an SUV. Recent MRI reports did not show rotator cuff tear, but did show tendonosis that you speak of. In your opinion would surgery help or make my situation worse ? Do you think surgery is necessary ? Or can the body really heal itself with physical therapy ? Please help. Contemplating surgery as proposed by Orthopedic surgeon.

[@GordonPhysicalTherapy]

That's a great question, Donna! If your MRI didn't show any tears in the RC muscles, and you don't suspect any frank tears, I would suggest trying PT first. Since you've had some success with PT in the past, it stands to reason that it should help again. However, if you don't experience any relief or healing with PT, then you might go back to the surgeon to discuss other options. Does that help, Donna? - Luke

[@brentmarquez4157]

I think I might have developed some tendinosis in my upper inner arms from typing at the keyboard. Dull aching and tightness on both arms - feels like its coming from just above the caracobrachialis in between that and the short head connection of the bicep on my inner arms near the armpits - accompanied by some mild stiffness behind on the triceps where the back of the armpit is. Best way I can describe it is inner upper bicep aching and tightness if that helps. No bumps or anything like that(don't think it is lymph nodes) and the area is tender. Lasted for many months now. Everything online is about mouse shoulder and tennis elbow from keyboard use but I don't have any of those symptoms. I got an ergonomic keyboard and mouse to try, so far not much improvement. Have you seen this type of RSI before and recommend treatment?

[@GordonPhysicalTherapy]

Hi, Brent. That's not a real common spot for tendon issues, although it's possible... have you had anyone check it out yet? Since it's close to the armpits, you do want to rule out other issues related to the lymph nodes and immune system...

[@brentmarquez4157]

@@GordonPhysicalTherapy I consulted a tendonitis specialist and though he said the same that it is uncommon to have tendonitis in that area, he thinks it may be treated the same as a shoulder tendonitis condition involving some of the muscles around the armpit area. I only get the pain when holding my arms at the keyboard or mousing, and no lumps and I feel fine, so I don't think it's lymph nodes. I've been doing ice massages and taking magnesium, vitD3, B6/B12 supplements. I'm open to any suggestions - I've run into other people in comment sections that also have the same pain and can't get answers as well. Open to any suggestions or even a guess as to how to treat it.

[@SpineSplitter1776]

The best description of what I have but mine is double the size of the other side & it seems to be cracked or snapped,the bump on the top can be separated about 2 millimetres! My surgeon said he never seen that before! My whole arm drops out of socket if I relax it! I would love to know if I could fix this after 20 years of this! I did have an extreme sports life so what can ya do😏

[@GordonPhysicalTherapy]

Wow, that sounds intense! Have you had an MRI of your shoulder yet? If it drops out of socket every time you relax, you likely have some serious instability (most likely related to your extreme sports lifestyle). Rotator cuff strengthening can help at times, although surgery if often needed to correct serious instability. What did the surgeon recommend? One more thought: have you tried any type of taping, like k-taping or McConnell taping? Taping can be helpful at times as well...

[@ritikasomani]

Hi, really informative video.. In mri the report shows musculo-tendinosis of abductor pollicis brevis. I am taking ust therapy since 10 days. Can you tell me what strengthening and stretching exercises to do?? It's been two and a half months since the injury. Thank you

[@GordonPhysicalTherapy]

I'm not an expert when it comes to the hands/thumbs... however, you should be able to find some strengthening videos if you search for them. Just keep in mind that any stretches or strengthening you do shouldn't increase your pain. You want to focus on healing and pain reduction first. I hope that helps! - Luke Gordon

[@rambleon2011]

What about this MRI diagnosis, is this also the same as tendinosis? “tenosynovitis of the long head of the biceps tendon”

[@Katie-vy5rd]

The mri report read tendonopathy! Of my gluts and hamstrings

[@GordonPhysicalTherapy]

That happens! Time to get some treatment if you can!

[@pratikshyadawadi8425]

Hello Thank you for the video. I have been diagnosed with marked tendonisis of the common extensor with probable partial thickness tear. Are stretching exercises good for the condition. Please provide me some insights. Thank you

[@GordonPhysicalTherapy]

Is this the extensor tendon for your wrist/forearm? Yes, stretching helps in general.

[@rachelpahnke1923]

Hi Luke , great video I was wondering if you could give me some advice. I’m a yoga teacher and about a month ago I had to stop teaching because of an aching pain on the outside of my calf, the pain is on the outside of my leg from my knee to my foot. Sometimes the outsiders of my knees hurt too. It’s in both legs. Anyway the doctor said I have tendinitis but after a month of rest and Ice it hasn’t improved. My employer wants me to go back to work, but I’m not sure if teaching yoga is safe yet? Also should I get an MRI? I really want to know what’s wrong with me.

[@GordonPhysicalTherapy]

Hi, Rachel. Here's what I would do in your situation. First, you want to make sure you know what's causing your pain. It could be muscular (hopefully), but it could also be related to your lower back. Once you figure out the cause, then you can get down to business and try to eliminate the pain. If it's muscular, something like the peroneal muscles are irritated, you'll want to do things like stretches (calf/gastroc stretches work nicely) and massage. You can do self-massage with various things like balls, foam rollers or hand-held rollers. One more key thing: if you feel like you can solve this problem by yourself, then go right ahead. However, since you've already been dealing with it for a month, I wouldn't wait too much longer to enlist some help. My best advice would be to find a PT in your area who's experienced with your type of pain. I know quite a few PTs across the country (if you're in the states), so if you need help finding one, just let me know. I hope that helps! - Luke Gordon

[@jayeshv100]

Hi Luke , Awesome content really helps me understandings the concept . My MRI report says Mild to greater cutaneous thickening with subcutaneous scarring appearing T2 hypointense noted overlying the lateral malleolus.this is nonspecific and could be represent fibrotic scarring from prior insult.no invert subcutaneous odema or discrete collection .this corresponding to the site of pain marker. Mild tibialis posterior insertional tendinosis. Could help me in understanding I m getting shock like or sudden cramps . taking treatment from 1 months but no improvement seen till date . Thanks

[@GordonPhysicalTherapy]

Thanks, Jayesh! It sounds like some of the muscle tendons around your ankle have some tendinosis. Is treatment at all yet? Even temporary pain relief?

[@jayeshv100]

@@GordonPhysicalTherapy Hi Luke, yes I was in hospital for 5 days and I was given injections and medications. I've been taking treatment since 1 month and taking medicines twice a day. But even after getting discharged from the hospital, I'm still getting a shock like pain (tingling sensation) below my calf occasionally. It has improved slightly since that time because that time it used to cause excruciating pain in the ankle. But now when the ankle is a bit twisted, it causes some small shocks. I have been wearing ankle support shoes as suggested by the doctor whenever I go out.

[@GordonPhysicalTherapy]

@@jayeshv100 thanks for those details. Since the hospital, are you working with a PT or doing any type of rehab? The injections and hospital stay will only get you so far (temporary relief) at best. Going forward, you'll want to work with someone who can help you fully heal. At least that's my opinion ;-)

[@maritess8816]

Hello! I would like to ask a question. My right shoulder and my neck is sore. It is not painful but I can see the that my right nape or shoulder is more fatter than the left one. I still have my range of motions like I can still raise my right arm and rotate it and it is not painful or when I reach something it is not painful. When I continue to use my right arm then it swelled more. It still looked like it is swelling even if my exercises are done few days ago. I am thinking of going back to my physical therapist. Do I have a tendonitis or tendonosis? I think it is my neck because it looks like it is in the right side closer to the nape. Sorry I cannot explain very well because English is my second language.

[@GordonPhysicalTherapy]

I would definitely have your PT check that out for you. If your arm is swelling, it could be a tendon issue, but it could also be a circulation issue, such as "thoracic outlet syndrome". So you want to make sure you know what you're dealing with! I hope that helps.

[@SkinWalker6182]

Thanks doc

[@GordonPhysicalTherapy]

You're quite welcome!

[@user-pl2ff9jn5r]

Hi Gordon! Hoping you can help point me in the right direction. I’m an active 30 year old who has been kickboxing 3-4 times a week for the past four years among other activities. For the past six months, I’ve been experiencing pain in my left knee and was eventually diagnosed with tendinosis and a lateral collateral ligament sprain. I saw an OT, had an MRI, and have been going to PT for the past month. I’ve been enjoying PT but my physical therapist said she’ll have to send me back to the orthopedic after two more appointments and I might have to consider a cortisone shot (which I would like to avoid - I feel like it’s putting a bandaid on the issue and not fixing it). Any advice?

[@GordonPhysicalTherapy]

Hi, Shannon. I would avoid that cortisone shot if possible as well. With you current PT visits, what types of interventions are you doing? Any hands-on treatment? As long as you're making progress with PT, I would continue. But if you're not making progress, you might seek another PT opinion.

[@benmullard4886]

I am 34yoM have been suffering with pain around my left hip for about 8 months now. This started from me using a car racing simulator and left foot braking with a very hard brake pedal. It’s been getting better slowly with rest and some gentle exercises along with not going on the simulator as much and using a softer brake pedal. How ever it still feels sore over my left hip and I often get a sound when rotating my hip or extending it. A recent MRI showed I have hip dysplasia, likely FAI and tendinosis of my rectus femoris direct head. I’m persisting doing exercises to try and strengthen the tendon but it’s seem to be taking a long time to get better. I assume the sound I get is the tendon flipping over the femoral head as it’s thicker and the femoral head more exposed? Should it be possible to get the tendon to fully heal over time? Thank you for any advice

[@GordonPhysicalTherapy]

Hey, Ben! Sorry to hear about your hip pain... yes, that noise is most likely your tendon moving back and forth over some part of your hip, although you can get noise coming from the joint at times too (it's less common). Your tendon should continue to heal over time, with the right balance of stretching/strengthening and rest/recovery. Soft tissue never heals 100%, but you can get close. Good luck!

[@KitzuneBlue]

Hello, thank you very much for your video, I'm an electric guitar player and I've been struggling with wrist tendinosis on my left hand for a year, when I first got the diagnoses the doctor just told me to apply ice to it and wait for it to get better, but a year from then my wrist still hurts and feels numb, is there a solution for this? Thank you very much

[@GordonPhysicalTherapy]

Hi, KitzuneBlue. If you haven't done this already, I'd definitely recommend some type of friction massage. Ideally, this would be from a therapist in your area, although you can also try some self-massage techniques. Have you tried that yet?

[@KitzuneBlue]

@@GordonPhysicalTherapy Hi, thank you very much for your reply, I had not tried that yet but a friend also suggested that to me, I should definitely try it then, I'm a bit scared to do that on my own in fear I do something wrong I guess I should see a therapist, is there anything I should be careful when doing this? And does this ever fully heal or is this one of those things that never really goes away? Thank you so much for the support, it is very useful indeed

[@nairahhassep3984]

Steps please for rotator cuff tendinos at home please 🙏🏼 thank you❤

[@GordonPhysicalTherapy]

Here you go: kzbin.info/www/bejne/emSUq4h8arikppI

[@nanceer06nr]

Hello I recently got a shoulder mri and it says I have mild supraspinatus tendinosis. I’ve been having pain for the past 2-3 months. Stops hurting when I put my hand on my waist. Can you please tell me what can be going on? Thank you!

[@GordonPhysicalTherapy]

Sorry for the late reply! Are you still having this issue? If so, I'll be happy to explain a few things that should help :-)

[@kerimkulah5117]

hello, i have supraspinatus tendinosis for few months. I was doing weightlifting until i get mri reports. Ive been resting since 2 months and just doing eccentric exercies with band. My doctor applied prp and cortisone enjection but i feel like nothing changing. Can you suggest something? Should i start lifting with low weights?

[@GordonPhysicalTherapy]

Have you been working with a PT as well? You might have some motion restrictions they can help you clear up. Check out this video as well for some more advice of fixing tendinosis: kzbin.info/www/bejne/emSUq4h8arikppI

[@shitkicker5636]

Hi, would doing some eccentric bicep curls help me recover from bicep tendinosis?

[@GordonPhysicalTherapy]

Hi there, Shit Kicker! Yes, doing some eccentric strengthening is a good part of your recovery from biceps tendinosis. You just want to make sure that the exercises will be well tolerated and not cause extra pain or inflammation. If you're at the point where you have your pain under control, your range of motion is good, and you can tolerate basic strengthening well, you're probably ready to slowly incorporate some eccentrics. Let me know if you have any other questions! Good luck!

[@user-ki4nu8tl5s]

Hi, I don't know how to identify if i have or not tendinosis. The situation looks like this: 5 months ago I've been doing biceps 3 days in a row and i felt huge discomfort in the long head of the right arm. Since then, my shoulder and elbows at that arm are not letting me do even push-ups and the weirdest part is when im flexing my bicep to a 90 degrees angle it's staying straight, not pumped or curved. I am going to visit a doctor soon, but let me know your opinion, thanks.

[@GordonPhysicalTherapy]

Hi, Adrian. It's sounds like you may have torn the long head of your biceps, especially if the muscle doesn't bunch up when you flex your elbow to 90 degrees. I'd definitely have your doctor check it out. I hope that helps! - Luke Gordon

[@markburt783]

Hi, how do you tell the difference between 'stirring things up' to repair the tendon and irritating the tendon and causing more damage?? Reason being is that I have tendinosis of the rectus femoris and have had it for 3 years. I've been rehabing it for 8 months with eccentric strengthening, but any time I do positive hip flexion, i get an ache for a few days which scares me tbh. It's also aching more after i jumped over a stream whilst hiking (not a good idea). Thanks for the video!

[@markburt783]

the ache btw is like a feeling i have to stretch my hip flexor out and no matter how much stretching i do it doesn't go away. I've tried NO patches, they seem to help btw and would recommend them.

[@GordonPhysicalTherapy]

That's a great question, Mark! And I apologize for my delayed response. It's a fine line between "stirring things ups" and causing more damage. When exercising the involved muscles, I would shoot for a "muscle burn" type of pain vs. other types of pain. Once your "good pain" turns into "bad pain", I think you've gone too far. How are you doing these days? Is the rectus femoris muscle still bothering you?

[@markburt783]

@@GordonPhysicalTherapy thanks for the reply. I actually had a breakthrough with it earlier this year after many years of pain and frustration. So I was off work for 5 weeks due to corona. I was lying around rather than being sat at a desk. Whilst spending most of my time horizontal I was also in a de-stressed mood (thankfully) because my job was secure and I live out in the country. For exercise I was doing short runs every other day or so, doing my strength exercises and yoga with hip stretches. The result was that the tendon finally got some resilience back and the combination of everything really made a huge difference. So in the past I had done tons of physical work but not saw the results I had hoped for. It seems obvious to me know it was the external factors, such as stress and being sat at a desk all day, putting the rectus femoris in compression that seemed to be holding me back. So I'm back to sport, did an xtreme triathlon of sorts in Sept and this lunch time I was even doing hill sprints.... I didn't think this would be possible for me when I asked this question!

[@markburt783]

Now*

[@GordonPhysicalTherapy]

@@markburt783 wow, that's great to hear! One of the "silver linings" that came out of COVID... you realized how much stress and prolonged sitting can negatively impact your health. I'm happy to hear that you're doing well, and I hope you continue to stay active and healthy!

[@jasonh3319]

Need your help!! Have RA in my shoulders as well as tendonitis the pain is various from a sharp pain, constant discomfort, dull ache or sudden weakness amd stiffness/pain from top of shoulder to the neck. Episodes of this started early July amd,it's now mid october leading me,to believe it must be tendinosis but would it still be hurting this much if it was tendonosis? Everything I do aggravates it especially driving. The Intense pain I feel comes at top of shoulders and along the collarbone also right above armpit in the joint. Wondering what pains are,from RA and which are,feom the tendon issues and if my,RA is inflaming the tendons. So confused

[@GordonPhysicalTherapy]

Hi, Jason. As it turns out, I have RA as well, so I know how frustrated you're feeling! In my experience, the best thing you can do is get your RA under control as quickly as possible. For me, dietary changes and working with a naturopath for guidance were the best choices I ever made. Currently, things that will trigger my RA and which I avoid include: gluten, dairy, alcohol (I can do some), pork and eggs. That might not sound fun to eliminate those things, but it gets easier with time. And life without joint pain is worth the trade off! When it comes to your shoulder pain I'd suggest some gentle rotator cuff strengthening. Just make sure it's pain-free, and perform 3-4 times/week. Let me know if you have more questions!

[@jasonh3319]

Thanks for quick response, I'm wondering if the pain I'm having above armpit, upper arm, collarbone, top of shoulder and neck from my RA or is it from the tendons? Or a combination of the 2? Also since driving is painful amd seems to aggravate it should I stop driving completely for a few months? I stopped driving for a few weeks and seemed to get better in terms,of the sharp pains I would get after driving. After returning to driving (very rarely, have been driving only about 2.5 hours per week) still seems to be aggravating it just not as badly because I limit it but I still feel as though I shouldn't drive. I just want this to heal has been 3 months.

[@catalincata9043]

I was diagnosed with MRI that I have very mild tendinosis in mostly all the tendons that are connected to my elbow except the tricep. I've had it for 3 years now and im 20 years old. I want to get tenocyte implantation which is done by a company named Othocell. But before I do that can deep tissue massage or Eccentric loading and stretches help promote back normal healing with type 1 collagen without causing more micro tears and reinjuring the tendons on a micro level? also, what does very mild mean with respect to tendinosis? Thank you

[@GordonPhysicalTherapy]

Hi, Catalin. If you haven't already tried deep tissue or friction massage, as well as eccentric exercises, I would definitely give them a try before any more invasive procedures. I would just make sure you have a qualified therapist guiding you along, so you can avoid any potential damage. I really like various types of scraping massage for tendinosis, such as IASTM or Graston techniques (you can do these cheaper with Gua Sha tools from Amazon). Also, "mild" just refers to the severity of the tendon, meaning that only small areas of the tendon are involved. More advanced tendinosis would be either "moderate" or "severe". I hope that helps! Let me know if you have more questions. - Luke Gordon

[@catalincata9043]

Gordon Physical Therapy Thank you very much for the reply sir! So since i have "very mild" tendinosis, my tendons are still strong and would be able to withstand eccentric loading and deep tissue massage without aggrevating the problem?

[@GordonPhysicalTherapy]

Yes, I think you can reasonably assume that your tendons should be strong enough for those activities. The key is just to work with someone who knows what they're doing and can guide you along the process.

[@garagegymbros2198]

Hello, i was at the physiotherapist today for an ultrasound. My supraspinatus could have some tendinosis but he didn't say it as if he could see this very well. Is an MRI much clearer to get a correct diagnosis or doesn't it matter? The MRI is much more expensive for me to have, but I would like to know that I have not been able to do press exercises for 3 months.

[@GordonPhysicalTherapy]

Personally, I don't think shoulder MRIs are that useful, unless you feel like you need surgery. Unless you suspect a significant tear, I would try to heal the rotator cuff tissue, reduce your pain and then progress to increased resistance training and exercise. I made another video on this topic last week that might be helpful. Here's the link if you want to check it out: kzbin.info/www/bejne/qZDQimOmhNySi5o let me know if you have any other specific questions!

[@garagegymbros2198]

@@GordonPhysicalTherapy Thank you. I started with exercises through the physiotherapist. 3 sort of Shoulder External Rotation with light weights. I just don't feel any pain during this exercise. This seems good, but I feel a whole different pain during bench presses and flyes (which I don't do anymore) that started the injury. Coincidentally today discovered that a preacher curl also causes a lot of pain somewhere in the shoulder, but a normal bicep curl not at all. Think that when it stretches my rotator cuff the pain arises and otherwise not.

[@Carpediem617]

Hi. Thanks for video, i am very worried, bc i went to a specialist that looked at my shoulder for only 10 min, before injecting me with cortisol. I ended up with 3 injections with only 10 days between each! After that he diagnosed me with frozen shoulder. No mri or xray had been taken. I learnt after that he had misdiagnosed me, cause i demanded mri to be taken later and it showed tendinosis and bursitis. I am 9 months in, and have chronic pain. I am afraid that the cortisol has broken down the cartilage even more and made permanent damage. Is that possible or unlikely? I also learnt that you should wait at least 6 weeks in between each injection and not 10 days! I regret this so much, and feel very worried, and depressed. Hope to get your input.

[@GordonPhysicalTherapy]

Hey there, Carpe*. Having 3 injections in 10 days is something I've never heard of and certainly wouldn't recommend. Typically, the max for shoulder injections is 3 total, spread out by several weeks/months each. While I can't tell you if you're at increased risk of damage by having them so close together, I would agree with you not wanting to have any additional injections in the future. Since you can't change what happened, I'd encourage you not to worry too much about it and instead focus on what you can do to treat your shoulder. Easy for me to say, I know, but do your best! If your shoulder is still tight, weak and painful, focus on what you can do to improve those areas. If you have any more specific questions on those things, just let me know :-)

[@brooklynwagner7116]

I was diagnosed with tendinitis in both my hands they swell and get very stiff sometimes, the area is red or purple and warm.most swelling Is by the thumb and all I’m told is to ice elevate and wear a special brace is there anything else I can do to fix this?

[@GordonPhysicalTherapy]

That sucks! If you're up for it, I would try an anti-inflammatory diet. Something along the lines of Paleo: cut your gluten, your grains and your dairy for 30 days and see if that has a positive effect on your thumbs. Pain in your hands/thumbs is no fun!

[@kathimeci5179]

You're a superstar! I'll be contacting your office for a consultation.

[@GordonPhysicalTherapy]

Sounds great, thanks!

[@SanMan10100]

So if I've had this symptom of my achilles tendon not being very flexible since a basketball accident when I was a kid it's more than likely tendonosis. Right? Then are you saying that massages and beating it up a little causes it to get more blood flow to it? I thought that only muscle tissue gets direct blood flow injected into it and the tendons can only absorb their nutrition from whatever is surrounding it. If that's true then how do we promote the body to supply the tendon with nutrition? Ditto the above for the patella tendon of my knees.

[@GordonPhysicalTherapy]

Those are great questions, Santi! Let me try to answer all of them as best I can. First, yes I'd guess that you're dealing with tendinosis vs tendonitis, and it sounds like you have some long-term soft tissue tightness. That tightness likely extends throughout your tendon, as well as your muscles (gastroc and soleus). Massaging that entire complex (tendon + muscles) can be very helpful for improving blood flow to the entire region, and massaging the tendon can also improve the alignment of any scar tissue (and break up tissue adhesions). You're correct that tendons and ligaments don't really get any direct blood flow, so when you use things like heat and massage, you're bringing nutrient-rich blood to that entire region via the blood vessels in the muscles. So again, working the entire region is very important to bring as much nutrition and blood to the area as possible. Well-tolerated exercises also help bring blood flow to the region, and eccentric strengthening can be particularly helpful. I hope these comment help! Thank you for your questions! I might have to make a separate video about this...

[@SanMan10100]

@@GordonPhysicalTherapy Thank you for responding so indepthly at my inquiry Gordon. I appreciate it. And yes your comments definitely help. However there are a few things I'm not quite clear on. But before I get into that I'd like to know where you and your offices are located? I'm located here in Denver Colorado. And you mentioned something about making another video relating to the topic of what I was talking about. Of course I'd be extremely interested in that. So I will subscribe to your channel looking for it. Thank you. Now about some of the things you said that were a little bit unclear to me. One thing you said was something about gastroc and soleus. I vaguely remember those terms. When you say gastroc I think of the gastroc nemeus (which I think is the calf muscle. No?) So is that where the calf muscle inserts into that tendon? And when you say soleus I'm not sure. Is that the shin area? Anyway I like the idea about heating the area with a heat pad or something because although I have a piece of metal that I can scrape my ankle and patella tendons with doing so is sort of painful. You also say exercises can help. I can only think of calf raises for the ankle tendon. And maybe walking or running for the patella tendon. No? What exercises are you referring to? Also if I were to do the calf raises my tendon is not very flexible. Would a little triangular fulcrum under my feet be a good platform so I don't have to be required to stretch it as much? Again thank you for responding to my query. Hopefully I'll get another one. Have a good have a good day man.

[@user-oz2mq7jq8o]

Hi Luke, Awesome content. I was diagnosed with Pes Anserine Tendonitis 4 months ago. I am a basketball student-athlete. i didn't rest when the first time i got injured. i did a lot of stretching after workouts. My tendon didn't seem to recover after a month. I stopped training and cut off all my exercises including running. My doctor suggested I try Dextrose Prolotherapy, and I have already taken four injections. I wonder whether I should continue taking it. i asked my doctor if the condition has deteriorated into Tendinosis and how to treat it, but he couldn't give me an answer. I was wondering if it is possible (with time) to have a full recovery from this condition. i feel pain every time i jump or just crossing the road. thank you a lot!

[@GordonPhysicalTherapy]

Overall, yes you should be able to make a full recovery. Besides the injections, have you had additional treatment? There are various types of massage that should help, including friction massage (I like to use "gua sha" tools). K-taping can also be helpful.

[@user-oz2mq7jq8o]

​@@GordonPhysicalTherapy thank you so much for your reply! i tried k-taping when i first got hurt. i wonder whether i should get myself taped every time i walk. i am pretty sure that i got Tendinosis. i've heard that Eccentric Contraction can help rebuild my tendon fibers into the correct direction. however, i don't know how to do it properly. btw is there anything else i can do and how long would it take for me to recover.

[@simpleVipul]

Hey, thanks a lot for the video. I was diagnosed with supraspinatus tendinosis a month back. Have been doing some shoulder exercises but, it has helped little and the shoulder feels heavy sometimes, Can you recommend me some specific exercises?

[@GordonPhysicalTherapy]

Hi, Vipul. I have a video showing some basic shoulder/rotator cuff exercises: kzbin.info/www/bejne/jaaToYVmer2rd5Y I need to make a newer version more specific to tendinosis though... bear with me, and I'll have a new video up soon. Thanks!

[@amitsharma-ms7hw]

Vipul plzz reply, how did u diagnose supraspinatus tendinosis, I'm suffering with this from last 1.5 years. I did ultrasound, electric stimulation no improvement. plzz help me Gordon sir. Can't ultrasound and electric stimulation diagnose this?

[@simpleVipul]

@@amitsharma-ms7hw The diagnosis can be done using a MRI report. You need to regularly do shoulder strengthening exercises for a long time to see some improvement. The most important thing is to prevent more injury, so its important to not exert too much pressure on the injured shoulder while exercising. Try to slowly increase your strength and after some months you will see good recovery. Good luck for your recovery.

[@amitsharma-ms7hw]

@Vipul Upadhyay.. what is the process did u first heal it and then started exercise or what ?

[@amitsharma-ms7hw]

@@simpleVipul exercise is the key isn't it. Like it'll heal the damaged tissues and at the same time it'll provide strength also

[@MichelleDespres]

What is tendinopathy of the supraspinatus? I have that and sub deltoid bursitis.

[@GordonPhysicalTherapy]

"tendinopathy" is a general term for a tendon issue, which could mean tendonitis or tendinosis (that term isn't very specific). The supraspinatus is one of your rotator cuff muscles, and it's the one that's most commonly irritated, especially with repetitive use. Sub deltoid bursitis is inflammation of one of the nearby bursa sacs.

[@KColes63]

I have tendonosis and bursitis in both my shoulders. I was diagnosed over 2 years ago after caring for my 95 year old mother (lifting etc) for 10 years....I have tried massage and osteopathy and am still in pain...I am wondering what the options are..

[@gelvansallim6861]

Hello I have the same problem how are you today. Did it get better ? Any fix ? Or tips ? Thank you :)

[@GordonPhysicalTherapy]

Hi, Katherine. Sorry for my late reply... are you still dealing with the shoulder pain? Any luck getting rid of it over the last year?

[@TheDoooburner]

My tendinitis didn’t heal at all during quarantine. I took anti-inflammatories, rested, and iced it a good amount. Is there other ways to help it? It’s in the Ulnar part of my wrist and haven’t lifted weights or played golf for almost 5 months and it’s still not healed.

[@GordonPhysicalTherapy]

Hey, Duncan. If that anti-inflammatory approach didn't work, I'd consider trying to increase the blood flow instead (which I prefer for a lot of tendon issues). In this case, I'd start using heat as well as some type of massage (friction massage if it's not too painful). Stir the tendon up a little bit to increase the healing response. Does that make sense, Duncan?

[@vlogswithvy]

I am diagnosed with mild tendinosis in the supra and infra spinatus and subscapularis and the pain is misery nothing helps i even got on strong pain meds it did nothing. im in p.t but my muslce shakes from the pain of the tendons. how long do you think it'll take i was going 3x/week for four to five weeks now 2x/week but i caused more damaged by rearranging my room and now im getting the injection...shoild i get another mri ?

[@GordonPhysicalTherapy]

Hi, Vy. Did the PT sessions help at all? Were they able to help reduce your pain before trying too much strengthening (which can make the pain worse)? If you get an injection, I'd recommend you pick back up with your PT sessions, assuming they were helping you in the first place.

[@vlogswithvy]

@@GordonPhysicalTherapy hi! the p.t did help but i was making as slow as a turtlle progress and then sat myself back just doing house chores, and my specialist thinks that this could be a slap tear? and so im waiting on taking an arthrogram in two weeks so ive just been doing at home p.t (with no pt knowledge)...but he didnt give me the innjection for the pain because he thinks it would make it worst? and sometimes i felt like doing therapy 3x a. week was causing too much and im already a stressed person as it is

[@amitsharma-ms7hw]

very well explanation. In my MRI report written there, SUPRASPINATUS TENDINOSIS and there is ACROMIO - CLAVICULAR ARTHROSIS. I'm suffering with this pain from last 1.5 years. I did ultrasound, electric stimulation but didn't get effective result, still it hurt. Every time I go to therapy center they say it's not an issue they recommend just few exercises. But it don't reduce my pain. plzzzz reply I've lot of more question to ask.

[@GordonPhysicalTherapy]

Hi, Amat. Thank you for your questions, and please forgive my delayed response... busy times! Hopefully my other videos that you've commented on have been helpful, and I'll make a few points today as well. First thing: hands-on therapy is a must for helping to heal your rotator cuff issue. Even just a basic massage can help improve blood flow to the area. I also like to use heat for this reason. Second thing: you do want to do some type of exercise, but you need to make sure that the exercises don't cause pain. I think you mentioned this in another comment on a different video, the idea of starting with isometric exercises, progressing to concentric, and then progressing to eccentric. I'm going to explain this in more detail in a future video, hopefully next week. So, make sure the exercises don't cause additional pain. If you're at the point where you can do eccentric exercises with a light resistance band without increased pain, then keep it up! (3-4 times/week is best, with rest days in between). Does that answer most of your questions, Amit? Feel free to keep asking on this thread :-)

[@amitsharma-ms7hw]

@@GordonPhysicalTherapy thanks for you response. My pain is going down. I'm feeling comfortable now. Currently i'm taking physio session with a chiropracter. His session helped me a lot at the same time i found your video diff between tendonitis and tendinosis and that made my recovery fast.

[@amitsharma-ms7hw]

yes I'm doing eccentric exercise with a light resistance band & there is no pain. So should i continue it or i should begin with isometric first. In one of your videos with towel you're doing external rotation, currently I'm following only this, could you plzz show some other eccentric exercises for supraspinatus tendinosis. And one more doubt my pain started from May 2018, I took MRI in February 2019 and from the last one week I'm feeling comfortable now so should I take MRI once again just because pain is chronic and to confirm tendinosis has not affected other part. ?

[@vishwanath1412]

hi in mri scan i came to know that im suffering from supraspinatus tendinosis. so how to treat and im confused that tendinosis means tear or what

[@GordonPhysicalTherapy]

Basically, to treat the tendinosis, you want to focus on comfortable strengthening of the supraspinatus, which could include eccentric strengthening. Tendinosis doesn't mean that the muscle is torn, but there is some damage to the tendon. In order to heal it, you want to find ways to improve the blood flow, and comfortable strengthening is an excellent option for this. - Luke Gordon

[@aryavirsangwan6837]

I have a question. I ran two-three miles for three days, with a day's break in between, and I’ve never had a achilles tendonitis issue before. I was sitting in a chair the wrong way for a couple hours, and when I got up, my achilles was in mild- moderate pain. this pain has more or less lasted the past two days, along with the thickening of my tendon. I maintain good flexibility, and have never had a achilles problem before. did i strain it or do i have tendinosis? thanks

[@GordonPhysicalTherapy]

Based on your history, I'd say you're dealing with Achilles tendinitis vs. teninosis, mainly because you haven't had an issue in the past. With any luck, you should be able to get the swelling down and not have any lasting issues. Let me know if you have any more questions!

[@aryavirsangwan6837]

Gordon Physical Therapy thank you! The tendon has become less thick, but it’s very stiff. The pain has also decreased over the past three days with icing and compression and whatnot. When do you think I will be able to run again? Thank you!

[@GordonPhysicalTherapy]

@@aryavirsangwan6837 I'm glad to hear the pain is improving! I would continue to stretch your calves and possibly consider some self-massage. Here's a video for the stretches: kzbin.info/www/bejne/nYmqoX6AjsasjtE. And here's one for the massage: kzbin.info/www/bejne/mZC9qqxjnZJmhKc. As for running, I would wait until you can walk and job without pain before you try running. Whatever you do, DO NOT try to run through the pain. I hope that helps!

[@MrApplewine]

If you have old tendinosis which is like a phase 3 and has finished healing and is not well healed then I'd say yes, stir it up. However, if you have only been in pain for less than 3 to 6 months and only have stage 1 or stage 2 then stiring things up while still in pain will probably only agrivate it more and cause greater degeneration and prevent it from healing. I suspect the thing to do is to let it heal for 3 to 6 months and after all pain is gone then do 6 months of low load physical therapy to strengthen it up to full strength. Something like that.

[@GordonPhysicalTherapy]

It's definitely a fine line you have to walk between stirring up the area to encourage healing and doing too much and making it worse. For most people, starting slow with the hands-on treatment and gentle stretches is a good way to start, and from there you can ramp things up. Taking 3-6 months off to heal is really difficult for more most people, and the inactivity can cause a lot of secondary issues to form. The trick is to pick the best starting point!

[@MrApplewine]

I recently saw the physical therapist and they said to try some basic movements and then try some isometrics in a week or two.

[@GordonPhysicalTherapy]

Sounds like a pretty easy start, which is a good idea. Any hands-on treatment yet?

[@MrApplewine]

They mentioned doing some tissue manipulation and maybe assisting the isometrics. I said I'd schedule one appointment for isometrics since we didn't get to that in the initial evaluation appointment. I suspect they just want me to keep going for visits so they can bill me. I'm not severely injured so I really don't need any assistance doing the movements. I really think with a single visit I should be able to be given a home treatment program and probably should have been given that on the first. I was given a paper with shoulder rotation, shoulder press, deep squat holding something close to body and shoulder blade squeeze, but we didn't get into the isometrics. I really don't have the energy or time to be going to a special location during the day to be doing physical therapy training.

[@GordonPhysicalTherapy]

It really depends on how bad you're feeling and how much your pain is impacting your abilities. Some people will need a full physical therapy treatment plan, while others just need to be pointed in the right direction. I hope your PT is able to help!

[@amysummerhays9968]

Is laser therapy or shockwave good for achilles tendinosis? Its painful and thickened on the sides of both ankles. Thanks

[@GordonPhysicalTherapy]

I'm not an expert on laser or shockwave therapy, but I've heard good things about both.

[@GrimmWolf-]

If I have had forearm tendonosis for 2 years, is it okay to still lift weights and try to inflame it like you were talking about? Is there a chance a tendinosis in my arm could rupture?

[@GordonPhysicalTherapy]

Hi, Daniel. That's a tricky question, but I'll do my best to answer it. Unless you're lifting very heavy weights, the chances of rupturing the tendon is probably very small. Also, it would be wise to start with a low amount of resistance before progressing to heavier weights. The strategy of doing eccentrics to cause some inflammation can still be achieved with lower weights/resistance, you just need to do more reps. Does that make sense? - Luke Gordon

[@GrimmWolf-]

Gordon Physical Therapy got it. Appreciate it sir!

[@GordonPhysicalTherapy]

@@GrimmWolf- you're quite welcome! I hope it helps :-) - Luke Gordon

[@Alelluyah144]

I have tendinosis and it hurts when I’m sleeping and waking up , it’s hell .

[@GordonPhysicalTherapy]

I'm sorry to hear that!

[@vennamanenishravan6314]

Dr. Please suggest me steps to cure quadriceps tendonosis. I'm not feeling comfortable in bending my knees completely. Should I take more rest or should I load gradually. Please suggest me.

[@GordonPhysicalTherapy]

Here's what I suggest: if you're not already stretching your quads, start that right away. Also start doing some type of self massage to your quads and/or your quad tendon (I can give you more specifics if needed). After you start those 2 things (stretching and self-massage, I'd start some gentle load-bearing exercises, such as mini-squats. I hope that helps! Let me know if you have more questions :-)

[@alexdunn2131]

@@GordonPhysicalTherapy I have same thing - quad tendonosis. Specifics on the self massage of quad tendonwould be great. Currently im using the lacrosse ball to hit the area above the kneecap and foam rolling and flossing quads/calves every day.

[@GordonPhysicalTherapy]

@@alexdunn2131 I don't have a video on this yet, but I'll probably make one in the next week or two. For now, I can try to explain a few things... One of my favorite massage devices is called a "gua sha" tool. Not very expensive and easy to use. This tool can be really good for self-massage. The lacrosse ball is good too, but using a scraping tool will give you a different feel, which I prefer. Another technique I like for the quad is foam rolling the quad while putting some tension on the quad using a stretching strap. Does that makes sense? It's a bit hard to describe...

[@peaches3854]

I have been having problems with my heel on my left foot, I also have broken and sprain it alot playing sports. The Dr said its tendonitis but it's been almost 2 months and it's still giving me problems, my husband have been helping me by rubbing it and he says the back of my heel feel larger then the other. I'm starting to think it's more going on with my heel.

[@GordonPhysicalTherapy]

Hi, Peaches. The foot and ankle issues can be really tricky to get on top of, as it's hard to not use your feet. Do you think you have more of a plantar fascia issue or an Achilles issue, or something else? Either way, you want to focus on doing as many things to ease the pain as possible, which can include any/all of the following: stretches, massage techniques, arch support, night splints, heat and/or ice. Does that help?

[@peaches3854]

I don't have much of a arch so maybe plantar issue, but I will try those things and I appreciate you getting back to me.

[@peaches3854]

@@GordonPhysicalTherapy I just say my therapist I am on my 2nd week of therapy and wearing a boot and still no improvements, cant walk for long period of time so now they have recommended shock therapy or see a orthopedic for injection. Which do you think is best?

[@GordonPhysicalTherapy]

@@peaches3854 if you're only on your 2nd week of therapy, I'd do more therapy before pursuing the other two options... or does your PT not think that more PT will help?

[@aayushgupta8964]

I am having supraspinatus tendinosis and my orthopedic have prescribed me NSAIDs. Should I take them??

[@GordonPhysicalTherapy]

That's up to you, but I'm not a fan of NSAIDs for tendinosis, as inflammation isn't the cause of pain. It's up to you and your doc though.

[@msbutterflyz]

Hi Doc, my ultrasound results stated: The biceps tendon insertions are normal with tendinosis. Do I have tendinosis or not?

[@GordonPhysicalTherapy]

It sounds like it, yes. I'm guessing it's just saying that the tendon is intact and not torn but that it has tendinosis.

[@msbutterflyz]

@@GordonPhysicalTherapy what a legend! Thank you for replying!

[@ritoriddhochakraborty-qt5io]

Hi mate actually I have a problem with my shoulder actually I am a cricketer i am pacer that day when the pain occur I was taking my action and ready for Bowl when I jumped and bowl a pop sound occurred on my deltroid and bicep muscle that doesn't feel any but second time when I Bowl the shit pain occur then my doctor suggested to rest I rest for a month cause I have some occasion after a month I was felling painless then when I set to Bowl and jump and deliver again the pain was occured on my deltroid from bicep and back of the shoulder I can't able to raise my hand on that moment. Then again my doctor give a medicine name "tendocare " and told me to do an Mri but mri report shows nothing abnormality on my shoulder the report says that. Then I showed to my doctor he told that I have tendinites with lateral damage I thought that my MRI report shows nothing and he says that I have a tendinites that' time I can't able to understand anything i have not an exact idea about this shoulder problem because this has first time occurred ..then I ignored the mri and got believe with my doctor then he suggested to do physiotherapy and told by physiotherapy it'will get better i done 2 time physiotherapy but it has not prevent and can't able to understanding nothing so mate help me with that I am stucked by this and become depressed then suddenly my doctor says it cannot be better physiotherpy it will need operation ugh!! Then I decided to not believe this doctor and i decide to visit another doctor then I fully shocked when the another doctor says it has happened nothing it will prevent to do swimming I fully shocked i thinking that I wasted a lot money to the previous doctor so mate I need ur help please sayy me how will it get prevent 😑 can it get better with swimming as my mri report shows no tear or nothing just I have a prob with bowling and throwing something with full force so plz tell how it get prevent I really want to get back my bowling the injury 8 month's and still now not get preventing so help me what can I do get better quickly please. 🔎

[@GordonPhysicalTherapy]

How long did you work with your physio for? Usually, with your type of pain, I would recommend doing physio for 12 visits (2x/week for 6 weeks). I can't tell you for sure what you need to get better, but you might consider doing more PT. I hope that helps!

[@andrewd5135]

I injured the tendon in my forearms, do you have any tips for that?

[@GordonPhysicalTherapy]

The tips I share in my video about "how to heal rotator cuff tendinosis" will apply to your forearm muscles as well. Does that help?

[@s.d774]

What should I do it my physiotherapist despite me telling her I've been in pain in the same spot for years and after 6 weeks of ice, rest, taping, bracing, different shoes it's even worse than before, she says it's just "tendonitis, not tendinosis?"

[@GordonPhysicalTherapy]

Do you have Achilles tendon pain? As long as your PT is treating you appropriately (with hands-on therapy, stretches and exercises) they can call it whatever they'd like. Do you feel like the treatments are following that outline and are helping?

[@s.d774]

@@GordonPhysicalTherapy Thank you for the reply! It is Peroneal pain, and she hasn't been doing any stretching. She just pushed on the painful spot, assessed my ankle mobility, told me to ice it and rest, and gave me stretches to do at home. I've been doing everything and the pain is even worse now. Also I am hoping to get further assistance and her diagnosis of tendonitis sort of feels minimizing because I've been suffering with this for years with no relief. I haven't been able to run, walk, or bike without pain for two years now. And even after days of not walking, and just sitting, it hurts just as much. Also, how can a physiotherapist say for certain it's tendonitis without looking at an M.R.I scan?

[@geoffreyreid2114]

Right at the end you said you have things like resting and improving ????? what was the word it was so fast .

[@GordonPhysicalTherapy]

I'm not sure, Geoffrey... I re-watched the video and don't know which part you're talking about... can you give me the specific time? Thanks!

[@geoffreyreid2114]

About 5.53 @@GordonPhysicalTherapy

[@GordonPhysicalTherapy]

@@geoffreyreid2114 thanks! At that point in the video, I mentioned progressing to "strengthening and flexibility, things like that". I had also been talking about inflaming the tissue but not overdoing it. Does that help?

[@crystalcyrus731]

I have chronic tendinosis will I ever be able to heal?

[@GordonPhysicalTherapy]

Hi, Crystal. The short answer to this question is yes, chronic tendinosis can heal. The trick is to do everything you can to improve blood flow to the muscle with aggravating it. This can include things like heat, various massage techniques (soft tissue, deep tissue, scraping) and pain-free strengthening. Ultimately, eccentric strengthening can be really valuable, but again you want to keep the exercises pain-free. I hope this helps! - Luke Gordon

[@sushilashukla1289]

Hi doc.My GP.said that my arm is sore because of the tendons. I'm 71yr.old.I do crochet baby blankets for charity .I feel that's what caused it.Will acupuncture help? I musing a wheat bag to keep warm and slowing down the crochet which I actually enjoy. Please advise .thank you. Love from South Africa

[@GordonPhysicalTherapy]

Acupuncture definitely helps at times. I'd give it a try :-)

[@sushilashukla1289]

Thank for reply doc.Shall I stop crochet?

[@justinbeckett3208]

I would greatly appreciate any advise.. 2 years out I had an avulsion fracture on my lateral ankle and as a result I have mild peroneal tendon sublaxation. I have already seen 3 different podiatrists and finally had an MRI showing surgery needed to correct the 'popping' I have come to terms with that. However, Ever since the injury Ive also had persistent irritation, redness and dull pain (very mild noticeable swelling) to the top of the foot and ankle. Neither of the 3 podiatrists could figure out why this occurs other then saying 'tendonitis'. They say it is not related to the peroneal tendon network of my ankle-foot though. I have to wear compression sleeves every day and constantly elevate when on my feet working. Any suggestions? Im trying self massage, epsom salt soaks, tens-unit, muscle rubs, numerous natural anti inflammatory supplements and lots of home therpay. I feel I have done everything humanly possible and Im now 2 years out from injury. Thank you for any advise.

[@GordonPhysicalTherapy]

Hey, Justin! I'm sorry for my delayed response to your question... I must've missed it. Are you still dealing with this problem? If so, I'll rack my brains and see if there's something I can suggest. I hope you're doing well!

[@justinbeckett3208]

@@GordonPhysicalTherapy Thank you for seeing the message. Believe it or not, I still deal with minor symptoms every day. This was back in 2016 and I've just gotten used to dealing with it. My last stop was a neurologist who did an EMG nerve test, it was all normal. His only thought was small fiber nephropathy that didnt show on testing, but I still don't buy that answer. I've gotten so used to ignoring it over the years, I stopped pursing a fix since years of daily PT and deep tissue work hasnt resolved the symptoms. I would love to be a case study for a network of therapists if such a thing exists, I know more people must suffer from a similar condition. Thank you for your time.

[@GordonPhysicalTherapy]

@@justinbeckett3208 thanks for getting back to me! It sounds like things have improved but not all the way... Since you've done all the traditional routes, and many of the natural routes, I would try some other therapies that aren't as well known. Specifically, here are a couple ideas: look for someone with a BEMER table in your area, if you haven't already. I can explain more, but if you Google BEMER, you should see some good info online. And my other recommendation would be to find a PT who specializes in fascial Strain Counterstrain. If you can find one who's taken the nerve and/or vascular courses, they might be able to offer you a unique treatment that you haven't tried before. Have you heard of either the BEMER or fascial SCS before, Justin? I can explain more if you'd like me to, so just let me know :-)

[@justinbeckett3208]

@@GordonPhysicalTherapy Thank you for the information and sharing. I have not heard of either method mentioned before. I have tried ultrasound and infrared, but never anything quite like that. I know all the local PT facilities around my area and none are practicing those methods that I am aware of. There are very few alternate health treatment options where I live aside from your basic chiropractors (which I will never go back to haha) Thank you for replying and the info.

[@GordonPhysicalTherapy]

@@justinbeckett3208 sounds good. I'm not sure where you live, but if you ask around on Facebook, there might be someone in your area with a BEMER device. Oh, and don't write off all chiropractors... like PTs, there are some really good ones, some bad ones, and quite a few in between! There are also some good massage therapists out there who practice more of the fascial release types of treatments. If you haven't tried that style of treatment, it might be worth doing. Good luck!

[@joshl1984]

I am hoping for some answers. I have to partial tears in both supraspinatus tendons which led to to bicep tendonitis I believe. I was doing rotator cuff exercises which seem to really help with my tendonitis. My physio therapist had me doing over head exercises to strengthen the bicep tendon but it just gets inflamed and irritated. I find that any sort of over head movements will irritate the tendons on both biceps. My physio therapist believes its tendinosis and is treating and not tendinitis . I'm so frustrated!! I cant get a head and my arms are burning from exercises. I feel like my shoulders were so much better when doing all the rotator cuff stuff and as soon as I started doing over head exercises all my symptoms returned. Not sure what to do and neither is my physio therapist

[@GordonPhysicalTherapy]

Hey again, Josh. That sounds frustrating... here's some simple advice that might help: unless they're a specific reason you're doing the overhead exercises, why not stop doing them? Based on what you just wrote, you felt really good with the rotator cuff exercises, and you only started dealing with the biceps pain when you added overhead strengthening. So again, would it work for you to simply cut out the overhead strengthening? Unless you have a specific reason for wanting overhead strengthening (like a specific sport or something like that), there isn't a whole lot that we humans do overhead. Just a thought... let me know what you think!

[@joshl1984]

@@GordonPhysicalTherapy Well I guess my physio therapist believes that because I have symptoms return from over head movements that it means my tendons are weak and need to be strengthened over head. With tendinitis, does the tendon need to be strengthened or just the rotator cuff around it need strengthening and the tendons to calm down with time.?

[@GordonPhysicalTherapy]

@@joshl1984 my personal opinion would be to focus on the rotator cuff strength versus trying to improve overhead strengthening. At the end of the day, if you cut out the overhead stuff, and you no longer have shoulder pain or difficulty with your typical activities, that's a big win. Your physio may disagree, and that's fine. But most people don't need overhead strength for daily activities. Almost everything we do strength-wise is below shoulder height. I hope that helps! Let me know if you have any more questions :-)

[@joshl1984]

what about burning sensation? is that normal with bicep tendonitis?

[@GordonPhysicalTherapy]

@@joshl1984 I would say a "muscle burn" sensation is normal when doing high amounts of repetitions. However, if you're having more of a painful burning sensation, No that's not normal. Can you differentiate between the too? If so, which are you experiencing?

[@millymc5010]

Just had a diagnosis of tend I noses in the shoulder after an ultrasound and the doctor has told me to take anti inflammatories for a week 🤦🏻‍♀️

[@GordonPhysicalTherapy]

Yeah... not the best advice... but very common advice.

[@doctorartin]

Thoughts on the utility of sick-leave for tendinosis patients? I've started my family medicine residency and get a lot of requests from physiotherapists to write sick notes for patients with long-term tendinopathies / tendinoses. Many of these patients feel pain but have full ROM. I've been trying to find evidence as to whether sick leave provides any improvement to the rehabilitation process, because usually the tendinosis returns once patients get back to work after 2-6 weeks of sick-leave. Thus I have refused sick-leave for patients with full ROM, and instead encouraged rehab and analgesitcs. Though I am uncertain whether I am doing harm or not to the recovery of these patients.

[@GordonPhysicalTherapy]

That's a tricky question, Artin... My personal preference would be to avoid sick leave if possible and instead focus on ways to improve the pain by figuring out the root cause. This of course could include many strategies, including things like modified-duty or light-duty. That would be my preference, but every situation has its own unique challenges. Does that help?

[@joshl1984]

is eccentric bicep curls for tendonitis or tendinosis?

[@GordonPhysicalTherapy]

Hey, Josh! Eccentric curls would be more indicated for tendinosis, in order to help improve blood flow to the biceps tendon. If you're dealing with tendinitis, just be careful you don't irritate the tendon too much... you want pain-free strengthening with tendinitis, so make sure to get the pain level down as much as possible before you try to progress to strengthening. Does that make sense?

[@joshl1984]

@@GordonPhysicalTherapy yes it makes sense thank you.

[@GordonPhysicalTherapy]

@@joshl1984 you're quite welcome!

[@MemeLord904]

I think I have shoulder Tendonosis . How should I treat this and should I be scared ? Is it possible to get a rotator cuff tear? I lift small objects all day but this was caused from a different job

[@GordonPhysicalTherapy]

Hi, Bryce. What makes you think it's tendinosis vs. tendonitis? In terms of treating it, you should be safe as long as you start with light resistance and keep your exercises pain-free. If in doubt, you can always work with a local PT. - Luke

[@MemeLord904]

Gordon Physical Therapy I had an MRI and they said I had minor tendonosis in the supraspinatus tendon and bicep. It hasn’t healed in over 8 months. Overall weekness and dull aches through the day.

[@GordonPhysicalTherapy]

@@MemeLord904 thanks for clarifying! Overall, I wouldn't be too worried about tearing either the supraspinatus or biceps tendons, especially if you're doing controlled and pain-free strengthening. In this situation, it would be very unlikely for you to damage the tendons. In the event that you did damage the tendons with controlled exercises, my viewpoint is that the tendons were going to tear on their own in a matter of time. But again, if you have mild tendinosis, I think you're in a good position to start with pain-free strengthening. For our patients in your situation, we also do hands-on therapy to improve the speed of healing, as well as to reduce any other muscular pain in the surrounding scapular muscles (like the upper traps and rhomboids). Good luck! Let me know if you have any other questions or need help finding a good PT in your area. - Luke

[@MemeLord904]

Gordon Physical Therapy thank you ! I just lift small stuff all day but I’m pretty sure if it was serious my body would let me know! Can’t imagine that kind of pain. Thank you for the video !

[@crystalcyrus731]

@@GordonPhysicalTherapy I have severe tendonois. So what should I do eat more Vit C going to help? IO cant rest because I need to use my arms for my job

[@davidhodgson7857]

What is your opinion of Shock therapy

[@GordonPhysicalTherapy]

Not real familiar with it yet...

[@ant_alegria]

Hi sir , My name is Anthony and I have lifted heavy weights from July to September and I had wrist pain . It has gone down but still happens . I haven’t had swelling or redness ,Is this tendonosis? If so how many months should i rest until i can lift weights again ?

[@GordonPhysicalTherapy]

It's hard to say if your wrist pain is a tendon issue or more of a joint issue... can you pinpoint your pain to any specific tendon that you can touch?

[@ant_alegria]

@@GordonPhysicalTherapy no sir i’m not sure but the pain goes from the side closer to my pinky. it isn’t the whole wrist and it’s made my grip strength a little worse.

[@GordonPhysicalTherapy]

@@ant_alegria just to clarify: is the pain along your palm side (not the back of your wrist)? And it's towards your pinky finger?

[@ant_alegria]

@@GordonPhysicalTherapy it’s hard to describe but it was the whole wrist now that i think about it .The best i can describe the pain is dull not sharp . But yes the pain is more on the side of my pinky finger.

[@GordonPhysicalTherapy]

@@ant_alegria okay, thank you for explaining. If your pain is more widespread in the wrist, I'd be more concerned with pain coming from your joint, which is common with weight lifters. Does any type of taping or stabilization help?

[@earthpisces2009]

Hey man my MRI showed Mild Supraspinatus Tendinosis.I go to the gym and now I can’t.Can you please tell how much time will it take to heal and how can I rush up this process.Also is there any way I can make gains in the gym?Please help bro!

[@GordonPhysicalTherapy]

Hi, Siddhant. The problem with getting the rotator cuff muscles to heal (like the supraspinatus) is that they don't heal very quickly on their own, due to their poor blood supply. This is why rest and ice alone rarely work. My best advance for improving the healing process is to perform well-tolerated rotator cuff exercises 3 times/week. These exercises can include "eccentric" strengthening as well. I'm going to make a video on this soon, so please stay tuned! Also, if the should isn't too flared up, I also recommend using heat in addition to the exercises and massage, to improve blood flow to the area. Does that all make sense?

[@earthpisces2009]

@@GordonPhysicalTherapy Yes that does and I will wait for the video!!Also it doesn’t hurt at all until I do some lateral movements and the pain is minimal.Do you think the MRI might be incorrect since the pain is negligible?

[@GordonPhysicalTherapy]

@@earthpisces2009, lateral movements are often painful with tendon issues, even if the tendon is just inflamed without any noticeable damage on the MRI. So no, I don't think your MRI is incorrect. Try to avoid those lateral movements while working on your recovery...they're not very functional in the first place, and they can cause a lot of discomfort even with a fully healed rotator cuff. Let me know if you have any more questions :-)

[@earthpisces2009]

@@GordonPhysicalTherapy Yeah just one more question.How much time can it take to heal a ‘mild’ supraspinatus tendinosis considering proper PT rest and ice pack.Also my MRI showed mild acromioclavicular joint arthropathy(in the form of thinning of cartilage)I’m 19,is it possible at such a young age?My doc suggested collagen sachets but is it a matter to worry or every gym goer might experience it.Lastly it showed mild thickening of CHL.Can you please tell me about these 2 things in details?

[@GordonPhysicalTherapy]

@@earthpisces2009 those are great questions! I'll do my best to answer them... first, regarding how long it will take the supraspinatus heal: assuming you're doing the proper exercises, with periods of rest and using ice when needed (although I recommend heat over ice), and considering your young age, I would estimate you could experience full healing within 4-8 weeks. This is just an educated guess, and we really wouldn't know without another MRI down the road. However, I want to point out one more factor to pay attention to: a big factor in your healing potential is avoiding things that aggravate the tendon. If you can find this balance (between strengthening, healing and avoiding aggravating activities) you have an excellent shot at full healing. Second, you mention AC joint arthropathy and thickening of the CHL ligament. At your age, these both likely represent some level of repetitive damage or wear and tear. And I think this leads us back to the last concept I mentioned: going forward, you want to make sure you're not regularly aggravating your shoulder. Depending on what your workouts typically include, you might want to give this some thought and possibly modify some of your workouts. I hope that helps! Thank you for your questions!

[@ashuraya2779]

i probably have Tendinosis cuz i have had pain 1 year now... On MRI the structur on the rectus muscle is same... But the tendon has been thickned... Please help me. What should i do now? Totaly rest for 2-3 weeks and then start rehab gradually or should i not rest and go for very heavy acitivties??

[@GordonPhysicalTherapy]

Which muscle group are we talking about? Is it the rectus femoris, with pain near the front of your hip? Also, what are currently doing now to treat the pain... any stretches or exercises? If you can explain those details a bit more, I can help point you in the right direction. Thanks!

[@ashuraya2779]

@@GordonPhysicalTherapy sir. I have had rectus femoris strain close to the hip 2 years ago and it got strained 3x in 5 weeks because.i didnt wait enough. After it became better i strated to play soccer as normal and i was doing strange movements to “could” pass, shot and run like i was before. I also trained strengthening exercises at home... all the period the hip pain strated growing gradually but i didnt care... so i overused the tendon alot and its now thickned. I even have rotation in lower back because of the over use and strange movemnts and power i used... Right now after i knew it has been rotation in my hip/lowerback i do only stabilisation for the lower back i stretch and do some exercises to get it straight and also the pain in hip decrease alot. I dont do strength or stretch. (If i do stretch i dont feel it and i feel pain also) I have pain in hip its like a little bit inflammation...but the main problem is that the tendon close to the old strained muscle is thickned and has less elasticity which also cause as i said pain and inflammation in the beginning of the hip and sometimes pain in lower back(if i dont do the exercises for lower back)because the thickened tendon makes one leg like “shorter” than the other one....

[@ashuraya2779]

@@GordonPhysicalTherapy Mr; here is what MRI said, its short please please be patient snd read it. MRI overview right thigh with comparison with left. In the right spinal iliaca anterior inferior, no repture of the muscle rectus femoris is detected. starting a few centimeters distal to it is seen gradual thickening of the tendon and mainly low-signaling thickening of the ventral perimuscular fascia around the muscle bike, with largest diameter about 23 X 6 mm, gradually tapering down to about 20 cm below the hip joint, with the appearance of fibrosis / post-traumatic residual changes. Within the thigh muscles, no edema changes or otherwise significant abnormal changes are detected in other respects.

[@GordonPhysicalTherapy]

@@ashuraya2779 I'm going to reply to your other comment, just before this one... thank you for sharing your MRI results!

[@GordonPhysicalTherapy]

@@ashuraya2779, you've really had a rough time with this! Thank you for sharing your back story, as well as your MRI results. Your situation is a bit tricky, but I'll try to give you some advice to get you going in the right direction. Here's what I think you should start with: some kind of warm-up exercise (like riding a bike), followed by pain-free stretching and some hands-on treatment to break up the scar tissue and improve blood flow. I'd also use a hot pack to increase the blood flow. After a couple weeks, if you feel like your pain is improving, I'd slowly add some gentle strengthening as well. Specifically, I'd recommend eccentric hip flexor exercises. Keep everything pain-free if you can, although a light/temporary pain is okay, as long as it doesn't last or cause pain the following day. Does that help for now? I can give you more advice down the road if you start to make some progress, so let me know!

[@heavenswarriors3244]

Have you treated fluoroquinolone toxicity? with partial tearing of gluteus medius r & L gluteus medius tendinosis.

[@GordonPhysicalTherapy]

No, I haven't heard of that diagnosis before, although I've treated plenty of gluteus medius tendon issues. What is fluoroquinolone toxicity? Is it similar to the muscular issues many people have with medications like statins and certain antibiotics?

[@heavenswarriors3244]

Gordon Physical Therapy yes fluoroquinolone is an antibiotic such as cipro, levaquine, Avalox. They now have a black box warning because they cause spontaneous partial and complete tares of tendons all over the body, sometimes immediately and other progressives over a period of years. Some have died and others completely paralyzed. The only relief I have had is from DMSO lineament.

[@GordonPhysicalTherapy]

@@heavenswarriors3244 I was afraid you'd say that... some of those antibiotics can be completely horrific to your muscle tendons. I once worked with a woman who had both Achilles tendons rupture due to using levaquine. Not good! Are you having any luck with your gluteus pain? I'm a big fan of "hands-on therapy" techniques plus heat and electrical-stimulation in the clinic, progressing to gentle hip strengthening when well tolerated. There are some k-taping techniques that are also helpful.

[@heavenswarriors3244]

Gordon Physical Therapy, I needed surgery to repair the complete tares, but due to complete and partial tares in both shoulders and hips, all I could do was keep still and wait for the pain to subside. But due to no narcotics used for this type of pain, I refused all surgeries. The pain eventually went away, but the tares remain and then new tares come in new areas. THC helps, but mostly just gets you high and puts you to sleep. These tares are not like tendon injuries because it is the mitochondria that are prevented from repairing itself in the monoclonal DNA level.

[@GordonPhysicalTherapy]

@@heavenswarriors3244 geez, what a nightmare! I'm glad that THC helps to some extent. Aquatic therapy might be another option for you, since it's a more comfortable environment to move about in. Have you tried using a warm pool for gentle walking/exercise?

[@hbualnkner]

Do you get tendinosis from one event?

[@GordonPhysicalTherapy]

Hey, there Mr. B. No, people don't tend to get tendinosis from single events. Instead, it tends to happen slowly over time. Tendonitis and muscle tears tend to happen with single events. I hope that helps!

[@areoh2005]

Hi, after practicing bar muscle up I've got pain in right elbow tricep insertion. I can feel it with finger. After 8 months its still there, though much smaller, but I can't come back to tricep excercices. 2 doctors and 2 therapiest said it's tendinitis (one said its tendinopathy though) and I should do for a few weeks negatives. That didn't help much. On olecranon there is a small spot, which is a bit painful if I rub it with a finger, but there is no pain otherwise. What do you think, is it tendinitis or tendinosis? Not sure if either fits. If I take ibuprofen, I can't find that painful spot for a day, so I assume it has some inflammation. Physically I can do push ups and even ring muscle ups, but not sure if I should because it can get worse. Have you seen / heard anything like this?

[@GordonPhysicalTherapy]

It definitely sounds like you have inflammation in that triceps tendon. If I had to guess, it's probably more of a tendonitis issue vs. tendinosis. Here are some things I'd recommend: first, do everything you can to heal the tendon and get to the point where it's no longer tender to the touch (and avoid ibuprofen if possible, as it won't help you with healing). Second, once the tendon is pain-free, focus on exercises that cause NO PAIN during the exercise, with no pain in the following 24-48 hours. After that, you can start easing back into more difficult/challenging exercises. Just make sure you don't have an irritate tendon along the way. Does that all make sense?

[@areoh2005]

@@GordonPhysicalTherapy Thanks for reply! I think getting rid of inflammation is the key unfortunately I don't know how to achieve that. I tried everything. Cold, massage, vitamins, negatives, pauses (I left elbow alone for a month), now I'm trying static holds (after watching Jill Cook). Leaving elbow alone helped a lot but progress stopped at some point. I've got tendinitis in my glut (confirmed by ultrasound, yeah, I'm quite old) after jogging and it gets better in 2 weeks (I think this is typical for tendinitis), but elbow is so weird :(

[@GordonPhysicalTherapy]

@@areoh2005 that's tough... in addition to what you mentioned trying, have you attempted any dietary changes, such as eliminating gluten/grains or dairy? Sometimes you have more of a systemic issue with inflammation vs. just a local tissue injury.

[@areoh2005]

@@GordonPhysicalTherapy Thanks! Last week I'm trying 8:16 fasting, I saw somewhere it has some anti inflammatory effect probably not true but it helps to control weight anyway (last half a year I gained 2kg because lack of calories can slowdown recovery process). Will try to remove gluten and replace wheat protein with chicken. Do you suggest to stop doing pull ups and rows? I don't feel anything in tricep, but last reps I'm strengthing whole arm, so may be tricep as well...

[@glenesk18]

is hot yoga a bad idea for some one with tendonosis of the knee?

[@GordonPhysicalTherapy]

Not necessarily, Elle. If you're doing hot yoga, I would just make sure that the poses you do are comfortable and don't aggravate your knee pain. If you do find that some poses are painful, I would either avoid them or work with the instructor to modify them. I hope that helps! - Luke Gordon