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Health education · MusculoskeletalSaint‑Hyacinthe
Pain in the shoulder, elbow, wrist, hip, knee or Achilles tendon? Pain that appears with certain movements or comes back during repetitive activities can sometimes be related to a tendon problem.
At Clinique IPS du Palais in Saint-Hyacinthe, our team can assess your musculoskeletal symptoms, look for the structure causing the pain and determine the care options suited to your situation.
Understanding
A tendon is a strong structure that connects a muscle to a bone.
When the muscle contracts, the tendon transmits this force to the bone and allows the joint to move.
Tendons are therefore constantly put to work in:
The word tendinitis is very commonly used. The suffix “-itis” suggests inflammation.
However, much persistent tendon pain is not caused solely by inflammation. The more general term tendinopathy is therefore often used to describe a painful tendon condition.
In everyday language, the two terms are often used to refer to the same type of problem.
Symptoms can vary depending on the tendon affected. They frequently include:
Some people feel more pain at the start of an activity, followed by temporary improvement as they move.
Affected areas
Tendinopathies can affect many areas.
The rotator cuff tendons are frequently involved. The person may, for example, feel:
Two problems commonly called tendinitis are:
Pain may appear with gripping, manual work or repetitive movements.
Arthritis Society Canada lists the sides of the elbows (lateral or medial epicondylitis) among the areas most often affected by enthesitis, that is, involvement of the points where tendons and ligaments attach to bone.2
Tendinopathy can affect certain tendons of the wrist or thumb.
De Quervain’s tenosynovitis, for example, can cause pain on the thumb side of the wrist. Certain repeated hand or thumb movements can increase the symptoms.
Some pain located on the side of the hip may be associated with the gluteal tendons. The pain may be felt, for example:
Various tendons can be affected around the knee. Patellar tendinopathy (patellar tendon), for example, may be associated with activities involving:
The Achilles tendon connects the calf muscles to the heel. Tendinopathy can cause:
Factors
There is not always a single cause. Several factors may contribute.
A sudden change in volume or intensity can overload a tendon: returning to sports, running more, a new training program or unusual physical work.
Certain repeated movements can increase the load on a tendon, particularly at work or in certain sports activities.
The way certain movements are performed can influence the load placed on a structure.
A tendon and the surrounding muscles may be less prepared to tolerate certain loads.
Over time, the structure and adaptive capacity of the tendon can change. However, this does not mean that tendon pain is inevitable with age.
Repetitive movements, prolonged postures, lifting loads and certain work tasks can contribute to musculoskeletal disorders.
Tendinitis and work
Musculoskeletal disorders can affect the joints, muscles, tendons, ligaments, cartilage or nerves.1
During the assessment, it can therefore be helpful to describe certain aspects of your work.
It can be helpful to specify:
Tendinopathy often develops gradually. A rupture or significant tear, on the other hand, can sometimes occur suddenly. A person may report:
An acute injury with significant loss of function warrants a prompt assessment.
A bursa is a small fluid-filled sac that reduces friction around certain joints. Bursitis is an irritation or inflammation of this structure.
Tendinopathy, by contrast, affects a tendon. The two can sometimes cause very similar symptoms and can even be present at the same time.
The clinical examination helps determine which structure is likely involved.
Osteoarthritis mainly affects the joint, whereas tendinopathy affects a tendon. Both can cause:
An assessment helps tell them apart.
The assessment is based mainly on the history of the pain, its location, the movements that trigger it, work or sports activities, how the symptoms have evolved and the musculoskeletal examination.
The health professional may assess, among other things:
In Quebec, public musculoskeletal clinics start with a complete musculoskeletal assessment, then direct the person to the appropriate services according to their needs.1
No.
An X-ray mainly shows bony structures. A tendon is generally not assessed on an X-ray in the same way as a bone or a joint.
However, an X-ray can be useful in certain situations to look for:
Not always.
A musculoskeletal ultrasound or an MRI may sometimes be ordered when it could change the management. However, these tests are not necessary for all tendon pain.
The clinical assessment generally remains the first step.
Rest
Not necessarily. Complete, prolonged rest is generally not the goal in common tendinopathy.
It can be helpful to temporarily reduce activities that greatly worsen the pain, while maintaining suitable activity as much as possible. A gradual return to loading is often part of recovery.
Exercises are among the approaches commonly used for tendon problems. Depending on the tendon and the phase of recovery, they may aim to improve:
For enthesitis, Arthritis Society Canada states that many flares can be managed with physiotherapy and eccentric loading strengthening exercises (the muscle works while slowly lengthening, as when you set down a weight).2
Physiotherapy can help:
In Quebec, public musculoskeletal clinics offer, among other things, information on pain self-management, self-care tools and personalized exercise programs.1
Cold can sometimes temporarily reduce pain. When the area is sore after an activity, applying cold may provide relief for some people.
It is best to avoid prolonged direct contact of ice with the skin.
Heat can sometimes feel good when an area is stiff or when the surrounding muscles are tense. However, it does not act on the cause of all tendinopathies.
The choice between heat and cold may depend on the person’s symptoms and comfort.
Medications
Certain pain treatments may be considered depending on the situation.
It is best to discuss the choice with a health professional or a pharmacist.
However, anti-inflammatories are not suitable for everyone, depending on factors such as:
Injections
In certain specific situations, a corticosteroid injection may be considered around certain structures. However, not all tendinopathies should automatically be injected.
The choice depends, among other things, on:
An injection given directly into certain tendons can also carry risks. A prior assessment is therefore essential.
The clinic also offers SportVis, a hyaluronic acid–based product presented on our services page for certain tendon and ligament injuries. Whether it is appropriate is determined during the assessment.
Platelet-rich plasma (PRP) is sometimes offered for certain tendinopathies. However, the scientific evidence varies depending on the condition treated. It is therefore not a routine treatment for all tendon pain.
Prolotherapy has been proposed for certain chronic musculoskeletal pain. In 2024, INESSS concluded that the evidence on its effectiveness is insufficient to draw clear conclusions, and that no clinical practice of prolotherapy for this pain is recognized by scientific organizations or learned societies.3
Clinique IPS du Palais therefore does not promote it as an option.
Recovery can take time. Some recent pain improves quickly once the load responsible is modified. Longer-standing tendinopathies may require several weeks or several months of gradual rehabilitation.
The time depends on factors such as:
Often, yes.
However, the activity sometimes needs to be adapted. Pain, loss of strength and the reaction in the hours following the activity can help guide progression.
An assessment helps determine which movements can be continued and which need to be temporarily modified.
Seeking care
A consultation may be appropriate if you have any of the following.
A quicker assessment is appropriate, for example, in the presence of:
These signs may indicate something other than simple tendinopathy.
For a non-urgent problem, when you don’t know which resource to consult, Info-Santé 811, option 1, lets you reach a nurse 24 hours a day, 365 days a year.4 In an emergency, call 9-1-1 or go to the emergency department.
Depending on your situation, our team can, among other things:
You can also discover our approach with Virginie Jacques, PHCNP, who has a particular interest in musculoskeletal health.
Frequently asked questions
No. That is why the term “tendinopathy” is often used for persistent tendon pain.
Some mild cases can improve with a change in activity, but persistent symptoms may require assessment and rehabilitation.
Not necessarily. Temporarily reducing or adapting certain activities may be more appropriate than stopping completely.
Yes. Progressive exercises and load management are an important part of managing many tendinopathies.
Not directly in most cases. However, it can show other problems that may be contributing to the symptoms.
Not always. It can be useful when the result is likely to change the diagnosis or management.
No. For certain indications, it can temporarily reduce symptoms, but it does not necessarily correct the cause or the tendon’s ability to tolerate load.
Yes. Tendon pain can persist for several months when it is not properly managed or when the factors that maintain the overload persist.
Tendinopathy affects a tendon. Bursitis affects a bursa located around a joint. The symptoms can sometimes be similar.
Tendinopathy mainly involves a tendon, whereas osteoarthritis affects the joint.
This page provides general information and does not replace an assessment by a health professional.
