Overuse tendinosis, not tendinitis - Part 1: A new paradigm for a difficult clinical problem

Overuse tendinopathies are common in primary care. Numerous investigators w orldwide have shown that the pathology underlying these conditions is tendi nosis or collagen degeneration. This applies equally in the Achilles, patel lar, medial and lateral elbow, and rotator cuff tendons. If physicians ackn owledge that overuse tendinopathies are due to tendinosis, as distinct from tendinitis, they must modify patient management in at least eight areas. T hese include adaptation of advice given when counseling, interaction with t he physical therapist and athletic trainer, interpretation of imaging, choi ce of conservative management, and consideration of whether surgery is an o ption.