Tendinosis is the chronic degeneration of a tendon (without inflammation) that begins with a cycle where breakdown exceeds repair in the tissue. It is an accumulation of microscopic injuries that don't heal properly over time. Pain comes from the separation of collagen fibers, mechanical disruption of the tissue, and the non-inflammatory biomechanical substances that irritate the pain receptors in the tendon.
Tendons are made up of mostly Type I collagen with a smaller amount of Type III collagen. When this tissue breaks down, the tendon tries to repair itself. However, the cells produce new collagen with an abnormal arrangement and makeup and Type III collagen fibers increase in number. The excess Type III collagen fibers weaken the tendon causing decreased tolerance of tensile stresses put upon it, thus increasing the risk for further or continued injury.
In order to break this cycle and to return to previous activities, a patient should see his/her physical therapist. The therapist will perform specific techniques such as deep friction massage, eccentric loading of the tissue, modalities and more to assist in the healing process and return the patient to his/her previous activities.