Sports
Tendinitis (tendinopathy) of the shoulder, elbow and Achilles: what it is and how it is treated
Tendinitis or tendinopathy in the shoulder, elbow or Achilles: why it happens, when to see a doctor and why progressive exercise is the foundation of treatment.
Short answer: tendinitis (now usually called tendinopathy) is pain in a tendon that is not tolerating the load you are placing on it. It is common in the shoulder, the elbow and the Achilles tendon. Complete rest rarely solves it: what usually helps is adjusting load and strengthening the tendon progressively with a guided plan.
Tendinitis or tendinopathy: what is the difference?
"Tendinitis" suggests inflammation. In many tendon pains lasting weeks or months, what dominates is a change in tendon structure and load tolerance, which is why professionals call it tendinopathy. For you, the practical consequence is that treatment is based on progressive loading, not just on reducing inflammation.
By area
| Area | Where it hurts | When it usually appears | Service |
|---|---|---|---|
| Shoulder (rotator cuff) | Outside of the shoulder and upper arm | Lifting the arm, sleeping on your side, overhead work or sport | Shoulder pain |
| Outer elbow ("tennis elbow") | Outside of the elbow | Gripping, typing or using a mouse, lifting with the palm down | Elbow pain |
| Inner elbow ("golfer's elbow") | Inside of the elbow | Strong gripping or throwing | Elbow pain |
| Achilles tendon | Back of the ankle, above the heel | Running, jumping, stairs; stiffness when getting up in the morning | Ankle pain |
Why it happens
- Sudden increases in load: more mileage, more training, a new task at work.
- Too little recovery between efforts.
- Low strength or control in the area and nearby joints.
- Other general factors (age, some diseases or medications) assessed by your doctor.
When to see a doctor first
- A blow or snap followed by loss of strength (for example, being unable to rise onto your toes after sudden Achilles pain).
- Marked swelling, warmth, redness or fever.
- Tingling or weakness spreading down the arm or leg.
How physiotherapy treats it
- 60-minute assessment: confirming the pain comes from the tendon, identifying which load irritates it and measuring strength and mobility.
- Load management: temporarily reducing or modifying what irritates it most, without stopping movement.
- Progressive [therapeutic exercise](/es/herramientas/ejercicio-terapeutico): tendon strengthening (for example isometrics, slow loaded exercises) progressed according to your response. Mild pain during exercise can be acceptable if it does not get worse the next day.
- Manual therapy or other tools as a complement, when they help you move with less pain.
- Gradual return to your sport or task, with exercises in my exercises and reassessments.
Tendons adapt slowly; consistency with the plan usually matters more than any single technique. Also see shoulder pain and common sports injuries.
Frequently asked questions
What is the difference between tendinitis and tendinopathy? Tendinitis suggests inflammation; tendinopathy is the term preferred today because in many persistent tendon pains a change in structure and load tolerance dominates over classic inflammation. In practice they are used interchangeably. Should I stop exercising if I have tendinitis? Complete rest is usually not advisable: the tendon needs load to adapt. Usually you temporarily reduce or modify what irritates it and load it progressively with guided exercise. Do ice or anti-inflammatories cure tendinitis? They can ease pain at times but do not replace progressive exercise. Medication is prescribed by your doctor. Are injections a good option? That is a medical decision. They may give short-term relief in some cases but do not replace progressive-loading rehabilitation; discuss the pros and cons with your doctor. When should I see a doctor for Achilles pain? Immediately if you felt a kick or snap at the back of the ankle and cannot rise onto your toes or walk normally: it may be a rupture.
Book your assessment
If tendon pain limits training, work or sleep, an assessment helps adjust load and set a plan. Book your 60-minute assessment via WhatsApp or at /es/agenda. Private, one-to-one (1:1) care at Torre Médica El Tesoro 2, El Poblado, Medellín. We also see patients in English.
This content is for educational purposes and does not replace an assessment by your doctor or physiotherapist.