Symptoms, Causes, and Treatments
What is Chronic Tendonitis?
Chronic Tendonitis (sometimes called tendinopathy) is a condition where a tendon—the strong connective tissue that attaches muscle to bone—becomes irritated, painful, or dysfunctional over a prolonged period of time. Unlike acute tendonitis (short-term inflammation), chronic tendonitis often involves degeneration of tendon fibers and abnormal pain signaling, leading to ongoing discomfort and reduced function.
Common Symptoms Include
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Persistent, localized tendon pain (aching, burning, or sharp with activity)
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Pain that worsens with movement or specific activities
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Stiffness or soreness, especially after rest or in the morning
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Swelling or thickening around the tendon
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Reduced strength or mobility in the affected area
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Pain flares after repetitive use or exercise
What causes it?
Chronic tendonitis develops when tendons are repeatedly stressed or injured and do not fully heal. Over time, this can lead to microscopic tears, collagen breakdown, and nerve hypersensitivity.
Common causes include:
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Repetitive overuse (sports, physical work, or repetitive motion)
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Poor biomechanics or posture
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Muscle weakness or imbalance placing strain on tendons
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Previous acute tendon injury that did not fully recover
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Aging-related tendon changes (reduced elasticity, blood flow)
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Nervous system sensitization that amplifies pain signals
Possible contributors include:
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Sports or occupational repetitive strain (e.g., tennis elbow, golfer’s elbow, Achilles tendon pain)
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Poor posture or improper movement patterns
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Weak supporting muscles or core instability
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Sudden increases in physical activity
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Systemic conditions (e.g., diabetes, arthritis)
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Psychological stress increasing muscle tension and pain perception
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Nervous system overactivation (central sensitization)
A Neuroplasticity-Based Approach
In chronic tendonitis, pain often persists even after tissues have structurally healed. This suggests a shift from purely mechanical injury to maladaptive pain signaling in the nervous system. A neuroplasticity-based approach helps retrain the brain to interpret tendon signals more accurately, reduce hypersensitivity, and restore confidence in movement.
At Menda, we use therapies that help retrain the brain and calm the nervous system. Approaches such as Pain Reprocessing Therapy, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy can help reduce the brain’s fatigue signals and restore balance. By teaching the nervous system new, safer patterns, people can gradually rebuild their energy, resilience, and quality of life.
You don’t have to keep living with these symptoms. Explore Menda’s evidence-based therapies designed to rewire the brain and restore balance.
Key Neuroplasticity-Informed Strategies
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Graded movement and exercise: Gentle, progressive loading of the tendon to rebuild strength and tolerance.
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Breathwork and relaxation practices: Reduce nervous system stress that amplifies pain.
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Movement retraining: Improving posture, biomechanics, and movement patterns to reduce tendon strain.
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Mindfulness and body awareness: Helping the brain reinterpret movement and tendon sensations as safe.
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Cognitive reframing: Shifting away from “injury = damage” thinking toward “nervous system hypersensitivity that can improve.”
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Consistency & pacing: Structured activity levels to prevent overuse while avoiding deconditioning.
Why Neuroplasticity Works
Chronic tendon pain often involves central sensitization, where the brain continues to perceive pain even if the tendon tissue is no longer acutely damaged. Neuroplasticity helps “rewire” these pain circuits by creating new, safe patterns of movement and reducing fear-based responses. This supports tendon healing, improves mobility, and decreases long-term pain.
When to Seek Care
Seek medical attention if you experience:
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Persistent tendon pain lasting longer than 6 weeks
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Severe swelling, bruising, or sudden loss of tendon function
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Inability to bear weight or move the affected joint
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Pain that worsens despite rest or self-care
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Pain interfering with work, exercise, or daily life
Healthcare providers who may help include sports medicine specialists, physiatrists, orthopedic doctors, or physical therapists. A combination of targeted rehabilitation and nervous system retraining often produces the best outcomes.
