Do you have a bad case of tendonitis? Tried everything to get it to heal, but it's still causing you pain. You're not alone. Patients frequently complain about tendonitis continuing to affect their running, walking, and jumping for months after the initial symptoms.
When it's your Achilles tendon involved, it can be seriously debilitating, affecting every aspect of your daily life. Little wonder that so many patients become frustrated.
We're answering the question "how long does it take to heal tendonitis" in this article. We'll explore the underlying causes and what you can do to speed up the process.
How long does it take to heal tendonitis?
Tendonitis vs tendonosis
Contrary to popular belief, tendonitis isn't a long-term condition. Podiatrists and doctors often refer to so-called "chronic tendonitis," where the symptoms continue for weeks, even months after onset. Yet, what they're really referring to is tendonosis.
Changing the term may seem irrelevant, but it's important for understanding what's going on. Tendonitis implies an active, ongoing inflammatory state (anything ending in -itis means inflammation). Such a condition can resolve itself within six weeks if treated. If the condition doesn't settle, then tendonitis can become chronic, turning into tendonosis.
Whereas in tendonitis, there is inflammation resulting from micro-tears in the tendon, in tendonosis, the inflammatory process has stopped. Instead, the actual tendon tissue is degrading. The two disease states are intrinsically linked, with one leading to the other.
In a nutshell: if your symptoms persist longer than six weeks, you likely have tendonosis. In such instances, symptoms may continue for weeks to months.
Estimated time to healing
How long it takes to heal tendonitis (or tendonosis) depends on the body part in question. In the upper body, elbows and wrists can continue to cause aggravation for six months or longer. In the lower limbs, symptoms will likely fade within a few weeks to months (including for Achilles tendonitis).
Why do tendon injuries take so long to heal?
Tendons are thick bands of connective tissue connecting the muscle to the bone. They're immensely strong. When you lift weights, it's the tendons that ensure muscle contractions act on bones to move the weight. That's why they've got the highest tensile strength of all your soft tissues.
However, despite their strength, tendons have a proverbial Achilles heel: an inadequate blood supply.
Insufficient blood supply means that when tendons become injured, they do not receive enough nutrients and oxygen to begin repairs. Rather, they receive nourishment via the synovial fluid, slowing the healing process.
Tendonitis occurs most often because of repetitive strain. At the microscopic level, by using a tendon repeatedly, tiny tears begin to build. If these tears occur at a rate faster than the tendon can repair them, then inflammation begins to occur. Cells within the tendon have to work harder and harder to repair and generate tendon tissue – soon, the demands of the cells outstrip their blood supply.
Tendons with the least blood supply – like your Achilles, elbows, shoulders, and wrists – are most prone to tendonitis. However, tendon inflammation can also occur due to blunt force trauma.
Conditions like diabetes, which affect the blood supply, and old age further impede this healing process. Such individuals are also at greater risk of tendonosis.
How to speed up the healing process
In the early phases of tendonitis, taking anti-inflammatory medications, like NSAIDs (e.g., ibuprofen, naproxen) and corticosteroids, can tremendously impact the disease progression. Since inflammation is dominant at this stage, these medications can help stop further progression.
Unfortunately, as the condition progresses, anti-inflammatory medications become less and less effective – as the disease state shifts toward tissue deterioration. That's the reason why discomfort persists so stubbornly.
Some studies even suggest NSAIDs can slow healing by interfering with collagen synthesis (the primary constituent of tendons).
You may also think that exercise would be dangerous for tendonosis. After all, they're much weaker, right? Yes and no. Yes, they're weaker, and so you should avoid intense exercises involving the tendon. No, you should not give up exercise entirely.
Eccentric training, whereby you emphasize the lengthening portion of a movement, has a growing evidence base. For example, if you are performing a bicep curl, you will perform the curl as normal, then as you lengthen the muscle, you do so slowly. Not only does this reduce muscle tightening, but it also increases blood flow, aiding repair.
Other potential curative treatments include massage to increase circulation, extracorporeal shockwave therapy, and even ultrasound therapy. Best of all, stopping smoking, gentle exercise, and a healthy diet will all improve blood flow and calm any lingering inflammation.
If you're struggling with long-term tendon pain, contact our expert podiatrists to schedule an appointment.
