Tendinitis and Tendinopathy: Diagnosis, Treatment, and Rehabilitation | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Tendinopathy is a degeneration of the tendon causing pain and dysfunction. Achilles tendinopathy, rotator cuff, epicondylitis, eccentric exercises, PRP, and physiotherapy in Quebec.\">\n<meta name=\"keywords\" content=\"tendinite, tendinopathie, tendinite Achille, \u00e9picondylite, coiffe rotateurs tendinopathie, exercices excentriques tendinite, PRP tendinopathie, tendinite traitement, tendinite physioth\u00e9rapie, tendinopathie Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Sports Medicine & Orthopedics & Family Medicine<\/span>\n <h1>Tendinitis and tendinopathy<\/h1>\n\n <div class=\"co-intro\">\n The term "tendinitis"\u2014which implies acute inflammation of the tendon\u2014has been largely supplanted in modern medical literature by the term "tendinopathy," which is more precise and accurate from a histopathological standpoint, as studies in electron microscopy and histology have shown that chronically painful tendons actually exhibit little or no cellular inflammatory infiltration (few neutrophils + few prostaglandins) but rather structural degenerative changes \u2014 disorganization and fragmentation of collagen fibers + abnormal neovascularization (vascular ingrowth) + increased amorphous intercellular matrix + and apoptosis of tenocytes (tendon cells) \u2014 a process known as tendinosis. This distinction is not purely academic: it has direct therapeutic implications, as anti-inflammatory drugs (NSAIDs + corticosteroids) that target inflammation have a limited beneficial effect and may be harmful in the long term for chronic tendinopathies (repeated corticosteroid injections weaken collagen and increase the risk of tendon rupture), whereas mechanical and biological therapies targeting collagen regeneration (eccentric exercises + progressive loading + PRP) are the most effective long-term approaches. Tendinopathies are extremely common in clinical practice\u2014accounting for 30 to 50% of all sports injuries\u2014and affect both competitive athletes and the general active population, particularly in tendons subjected to significant repetitive loads: Achilles tendon (runners) + patellar tendon (jumpers \u2014 jumper\u2019s knee) + rotator cuff tendons (shoulder) + epicondylar tendons (tennis elbow \u2014 lateral epicondylitis) + gluteus medius tendon + hamstring tendons.\n <\/div>\n\n <h2>Main tendinopathies by location<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Location<\/th>\n <th>Clinical name<\/th>\n <th>At-risk population<\/th>\n <th>Clinical trial<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Achilles tendon<\/td>\n <td>Achilles tendinopathy (mid-body or insertional)<\/td>\n <td>Runners + triathletes + masters + rapid increase in training volume<\/td>\n <td>Tender palpation of the tendon + arc of pain on palpation during mobilization + chair test (arc sign) + Royal London Hospital test<\/td>\n <\/tr>\n <tr>\n <td>Patellar tendon<\/td>\n <td>Patellar tendinopathy (jumper's knee)<\/td>\n <td>Jumping sports (volleyball + basketball + athletics) + adolescents + Osgood-Schlatter in children<\/td>\n <td>Pain at the inferior pole of the patella on palpation + VISA-P test + decline single-leg squat<\/td>\n <\/tr>\n <tr>\n <td>Lateral epicondyle (elbow)<\/td>\n <td>Lateral epicondylitis (tennis elbow)<\/td>\n <td>Tennis + badminton + repetitive manual labor (plumbers + painters + butchers)<\/td>\n <td>Pain on palpation of the lateral epicondyle + Cozen's test (resisted wrist extension) + Mill's test (passive wrist flexion with elbow extended)<\/td>\n <\/tr>\n <tr>\n <td>Medial epicondyle (elbow)<\/td>\n <td>Medial epicondylitis (golfer's elbow)<\/td>\n <td>Golf + tennis + throwing sports + strength training<\/td>\n <td>Medial epicondyle pain + painful resisted wrist flexion<\/td>\n <\/tr>\n <tr>\n <td>Rotator cuff (shoulder)<\/td>\n <td>Supraspinatus, infraspinatus, and subscapularis tendinopathy<\/td>\n <td>Throwing sports + swimming + overhead work + 40-60 years<\/td>\n <td>Neer Test + Hawkins-Kennedy + Jobe (painful arc) + Speed Test + rotator cuff resisted tests<\/td>\n <\/tr>\n <tr>\n <td>Gluteus medius (hip)<\/td>\n <td>Gluteal tendinopathy<\/td>\n <td>Perimenopausal women + runners + sedentary people<\/td>\n <td>Greater trochanter pain + worsened with crossed-leg standing + FABER + single-leg stance > 30 sec \u2192 pain<\/td>\n <\/tr>\n <tr>\n <td>Hamstrings (hip)<\/td>\n <td>Proximal hamstring tendinopathy<\/td>\n <td>Long-distance runners + cyclists + masters athletes<\/td>\n <td>Ischial tuberosity pain on palpation + aggravated by prolonged sitting + Puranen-Orava test<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Pathophysiology \u2014 Tendinous Continuum Model<\/h2>\n <ul class=\"co-list\">\n <li><strong>Stage 1 - Reactive Tendinopathy<\/strong> Rapid adaptive response (non-inflammatory) to acute overload \u2192 nodular thickening of the tendon + increased matrix \u2192 reversible if load is reduced quickly \u2192 do not stop activity completely (tendon atrophy) \u2192 manage load<\/li>\n <li><strong>Stage 2 - Dysrepair (early tendinosis):<\/strong> disorganized repair attempt + vascular ingrowth + abnormal cell proliferation \u2192 partially reversible \u2192 essential progressive rehabilitation<\/li>\n <li><strong>Stage 3 - Degenerative Tendinosis:<\/strong> major collagen disorganization + acellular areas + calcifications + abundant neovascularization \u2192 little to no structural reversibility + but can become asymptomatic with rehabilitation + high risk of rupture<\/li>\n <li><strong>Intrinsic risk factors:<\/strong> Age (> 35 years) + female sex (estrogen effect on collagen) + diabetes (collagen glycosylation) + hypercholesterolemia (intra-tendinous lipid deposits) + fluoroquinolones (direct tenocyte toxicity \u2192 risk of tendon rupture - particularly Achilles tendon) + systemic corticosteroids<\/li>\n <li><strong>Extrinsic risk factors<\/strong> Too rapid increase in training volume or intensity (10% rule % per week) + poor running or movement technique + unsuitable equipment (shoes) + playing surface<\/li>\n <\/ul>\n\n <h2>Treatment \u2014 stepped approach<\/h2>\n <ul class=\"co-list\">\n <li><strong>Fundamental Principle \u2014 Load Management:<\/strong> The tendon needs mechanical load to regenerate (load stimulates tenocytes + collagen synthesis) but overload damages it \u2192 the objective is not complete rest (deleterious) but optimized and progressive loading \u2192 maintain activity within pain limits (pain \u2264 4\/10 during and return to normal within 24 hours)<\/li>\n <li><strong>Acute phase \u2014 reducing the irritant load:<\/strong> Identify and reduce (but not eliminate) aggravating activities \u2192 substitute with low-impact activities for the tendon (cycling + swimming + unloaded exercises) + ice after activity (pain-relieving effect) + paracetamol or short-term NSAIDs (symptomatic relief) + brace or splint if necessary<\/li>\n <li><strong>Eccentric exercises (cornerstone of chronic tendinopathy treatment):<\/strong> muscular contraction during tendon lengthening \u2192 Alfredson's program for the Achilles tendon (200 repetitions\/day \u00d7 3 sets of calf raises \u2192 slow descent over 3 counts) + Stanish's program + pain reduction from 60\u201390 % to 3 months in Achilles and patellar tendinopathies + mechanism: stimulation of collagen synthesis + fiber reorganization + reduction of neovascularization<\/li>\n <li><strong>Isometric exercises (acute phase + reactive tendinopathies):<\/strong> Intense static contraction (70\u201380 % of maximal force) \u00d7 5 repetitions \u00d7 45 seconds \u2192 immediate pain reduction (cortical analogue effect) + no dynamic load on tendon \u2192 useful in the initial painful phase<\/li>\n <li><strong>Isotonic and plyometric exercises (progressive loading phase):<\/strong> Progression from isometric \u2192 slow isotonic \u2192 fast isotonic \u2192 plyometric \u2192 sport-specific activity \u2192 return to sport \u2192 progression must adhere to the absence of residual pain (> 24 hours) before advancing to the next stage<\/li>\n <li><strong>Corticosteroid injections<\/strong> short-term analgesic effect (4\u20138 weeks) + but does not alter long-term progression + repeated infiltrations (\u2265 3) weaken collagen + increase rupture risk \u2192 limit to a maximum of 1\u20132 infiltrations over time + do not infiltrate the body of the Achilles tendon (rupture risk) + associated bursitis may benefit from targeted infiltration<\/li>\n <li><strong>Platelet-rich plasma (PRP):<\/strong> Platelet-rich plasma (PRP) injection (growth factors + PDGF + TGF-\u03b2 + VEGF + IGF) \u2192 stimulation of tendon regeneration + randomized studies: mixed results but positive trend for chronic refractory tendinopathies (epicondylitis + Achilles) + less risk than corticosteroids<\/li>\n <li><strong>Extracorporeal Shockwave Therapy (ESWT)<\/strong> Acoustic microtrauma \u2192 stimulation of vascularization + collagen synthesis + desensitization of nociceptors \u2192 proven efficacy in calcific tendinopathies of the shoulder + epicondylitis + plantar fasciitis + 3\u20135 sessions weekly<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Fluoroquinolones (ciprofloxacin + levofloxacin + moxifloxacin) are associated with a significant risk of tendinopathy and tendon rupture\u2014particularly of the Achilles tendon\u2014up to several months after discontinuation of treatment. The risk is multiplied by 2 to 6 in patients over 60 years of age, those taking corticosteroids, kidney transplant recipients, or those with a history of tendinopathy. Any patient on fluoroquinolone who develops tendon pain should stop the antibiotic and be evaluated. Pain in the Achilles tendon while on fluoroquinolone warrants exclusion of a partial or imminent rupture.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Urgent medical consultation<\/div>\n <p>Consult emergency services immediately if sudden, intense pain accompanied by a \u00abpopping\u00bb sensation in the calf or heel occurs during exertion \u2014 especially in individuals over 40 years old, taking fluoroquinolones, or taking corticosteroids \u2014 as these signs may indicate a complete Achilles tendon rupture (positive Thompson's test = no plantarflexion when the calf is squeezed \u2192 orthopedic surgical emergency). For the assessment and management of chronic tendinopathy, Clinique Omicron offers medical consultations at its service points in Quebec and via telemedicine. To make an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Clinique Omicron's physician associates and nurse practitioners (NPs) diagnose tendinopathies through clinical examination (specific tests based on location), prescribe appropriate imaging assessments (ultrasound + MRI if rupture is suspected), initiate load management, and refer patients to physiotherapy for eccentric exercise and progressive loading programs, prescribe short-term NSAIDs for symptomatic relief, assess the indication for corticosteroid injections or PRP based on the clinical presentation, and screen for systemic contributing factors (diabetes + dyslipidemia + fluoroquinolones). Consultations are available at several service points in Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The content of this page is for informational purposes only and does not substitute medical advice from a doctor, physical therapist, or sports physician. A complete tendon rupture (particularly the Achilles tendon) is an orthopedic emergency. Repeated corticosteroid injections into a tendon weaken collagen and increase the risk of rupture\u2014limit to a maximum of 1-2 injections over the course of tendinopathy.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Tendinite et tendinopathie : diagnostic, traitement et r\u00e9habilitation | Clinique Omicron M\u00e9decine du sport & Orthop\u00e9die & M\u00e9decine de famille Tendinite et tendinopathie Le terme tendinite \u2014 qui implique une inflammation aigu\u00eb du tendon \u2014 a \u00e9t\u00e9 largement supplant\u00e9 dans la litt\u00e9rature m\u00e9dicale moderne par le terme tendinopathie, plus pr\u00e9cis et plus exact sur le… <a href=\"https:\/\/cliniqueomicron.ca\/en\/tendinite\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Tendinitis and Tendinopathy: Diagnosis, Treatment, and Rehabilitation | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Tendinite \/ Tendinopathie | Brossard | Clinique Omicron","_metasync_otto_description":"Tendinite \/ Tendinopathie Tendinite \/ Tendinopathie est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos profess...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Tendinite | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Tendinite \/ Tendinopathie Tendinite \/ Tendinopathie est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos profess...","_metasync_otto_twitter_title":"Tendinite | Clinique Omicron","_metasync_otto_twitter_description":"Tendinite \/ Tendinopathie Tendinite \/ Tendinopathie est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos profess...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Tendinite et tendinopathie : diagnostic, traitement et r\u00e9habilitation | Clinique Omicron","_aioseo_description":"La tendinopathie est une d\u00e9g\u00e9n\u00e9rescence tendineuse chronique avec d\u00e9sorganisation du collag\u00e8ne. Achille rotulien \u00e9picondylite coiffe rotateurs, exercices excentriques Alfredson 200rep\/jour, PRP ondes de choc fluoroquinolones risque rupture au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-10T07:39:06+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-24999","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Tendinite \/ Tendinopathie Tendinite \/ Tendinopathie est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. 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\n\t\t\t\t\t\n\n\n\n\nTendinitis and Tendinopathy: Diagnosis, Treatment, and Rehabilitation | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Tendinopathy is a degeneration of the tendon causing pain and dysfunction. Achilles tendinopathy, rotator cuff, epicondylitis, eccentric exercises, PRP, and physiotherapy in Quebec.\">\n<meta name=\"keywords\" content=\"tendinite, tendinopathie, tendinite Achille, \u00e9picondylite, coiffe rotateurs tendinopathie, exercices excentriques tendinite, PRP tendinopathie, tendinite traitement, tendinite physioth\u00e9rapie, tendinopathie Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Sports Medicine & Orthopedics & Family Medicine<\/span>\n <h1>Tendinitis and tendinopathy<\/h1>\n\n <div class=\"co-intro\">\n The term "tendinitis"\u2014which implies acute inflammation of the tendon\u2014has been largely supplanted in modern medical literature by the term "tendinopathy," which is more precise and accurate from a histopathological standpoint, as studies in electron microscopy and histology have shown that chronically painful tendons actually exhibit little or no cellular inflammatory infiltration (few neutrophils + few prostaglandins) but rather structural degenerative changes \u2014 disorganization and fragmentation of collagen fibers + abnormal neovascularization (vascular ingrowth) + increased amorphous intercellular matrix + and apoptosis of tenocytes (tendon cells) \u2014 a process known as tendinosis. This distinction is not purely academic: it has direct therapeutic implications, as anti-inflammatory drugs (NSAIDs + corticosteroids) that target inflammation have a limited beneficial effect and may be harmful in the long term for chronic tendinopathies (repeated corticosteroid injections weaken collagen and increase the risk of tendon rupture), whereas mechanical and biological therapies targeting collagen regeneration (eccentric exercises + progressive loading + PRP) are the most effective long-term approaches. Tendinopathies are extremely common in clinical practice\u2014accounting for 30 to 50% of all sports injuries\u2014and affect both competitive athletes and the general active population, particularly in tendons subjected to significant repetitive loads: Achilles tendon (runners) + patellar tendon (jumpers \u2014 jumper\u2019s knee) + rotator cuff tendons (shoulder) + epicondylar tendons (tennis elbow \u2014 lateral epicondylitis) + gluteus medius tendon + hamstring tendons.\n <\/div>\n\n <h2>Main tendinopathies by location<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Location<\/th>\n <th>Clinical name<\/th>\n <th>At-risk population<\/th>\n <th>Clinical trial<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Achilles tendon<\/td>\n <td>Achilles tendinopathy (mid-body or insertional)<\/td>\n <td>Runners + triathletes + masters + rapid increase in training volume<\/td>\n <td>Tender palpation of the tendon + arc of pain on palpation during mobilization + chair test (arc sign) + Royal London Hospital test<\/td>\n <\/tr>\n <tr>\n <td>Patellar tendon<\/td>\n <td>Patellar tendinopathy (jumper's knee)<\/td>\n <td>Jumping sports (volleyball + basketball + athletics) + adolescents + Osgood-Schlatter in children<\/td>\n <td>Pain at the inferior pole of the patella on palpation + VISA-P test + decline single-leg squat<\/td>\n <\/tr>\n <tr>\n <td>Lateral epicondyle (elbow)<\/td>\n <td>Lateral epicondylitis (tennis elbow)<\/td>\n <td>Tennis + badminton + repetitive manual labor (plumbers + painters + butchers)<\/td>\n <td>Pain on palpation of the lateral epicondyle + Cozen's test (resisted wrist extension) + Mill's test (passive wrist flexion with elbow extended)<\/td>\n <\/tr>\n <tr>\n <td>Medial epicondyle (elbow)<\/td>\n <td>Medial epicondylitis (golfer's elbow)<\/td>\n <td>Golf + tennis + throwing sports + strength training<\/td>\n <td>Medial epicondyle pain + painful resisted wrist flexion<\/td>\n <\/tr>\n <tr>\n <td>Rotator cuff (shoulder)<\/td>\n <td>Supraspinatus, infraspinatus, and subscapularis tendinopathy<\/td>\n <td>Throwing sports + swimming + overhead work + 40-60 years<\/td>\n <td>Neer Test + Hawkins-Kennedy + Jobe (painful arc) + Speed Test + rotator cuff resisted tests<\/td>\n <\/tr>\n <tr>\n <td>Gluteus medius (hip)<\/td>\n <td>Gluteal tendinopathy<\/td>\n <td>Perimenopausal women + runners + sedentary people<\/td>\n <td>Greater trochanter pain + worsened with crossed-leg standing + FABER + single-leg stance > 30 sec \u2192 pain<\/td>\n <\/tr>\n <tr>\n <td>Hamstrings (hip)<\/td>\n <td>Proximal hamstring tendinopathy<\/td>\n <td>Long-distance runners + cyclists + masters athletes<\/td>\n <td>Ischial tuberosity pain on palpation + aggravated by prolonged sitting + Puranen-Orava test<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Pathophysiology \u2014 Tendinous Continuum Model<\/h2>\n <ul class=\"co-list\">\n <li><strong>Stage 1 - Reactive Tendinopathy<\/strong> Rapid adaptive response (non-inflammatory) to acute overload \u2192 nodular thickening of the tendon + increased matrix \u2192 reversible if load is reduced quickly \u2192 do not stop activity completely (tendon atrophy) \u2192 manage load<\/li>\n <li><strong>Stage 2 - Dysrepair (early tendinosis):<\/strong> disorganized repair attempt + vascular ingrowth + abnormal cell proliferation \u2192 partially reversible \u2192 essential progressive rehabilitation<\/li>\n <li><strong>Stage 3 - Degenerative Tendinosis:<\/strong> major collagen disorganization + acellular areas + calcifications + abundant neovascularization \u2192 little to no structural reversibility + but can become asymptomatic with rehabilitation + high risk of rupture<\/li>\n <li><strong>Intrinsic risk factors:<\/strong> Age (> 35 years) + female sex (estrogen effect on collagen) + diabetes (collagen glycosylation) + hypercholesterolemia (intra-tendinous lipid deposits) + fluoroquinolones (direct tenocyte toxicity \u2192 risk of tendon rupture - particularly Achilles tendon) + systemic corticosteroids<\/li>\n <li><strong>Extrinsic risk factors<\/strong> Too rapid increase in training volume or intensity (10% rule % per week) + poor running or movement technique + unsuitable equipment (shoes) + playing surface<\/li>\n <\/ul>\n\n <h2>Treatment \u2014 stepped approach<\/h2>\n <ul class=\"co-list\">\n <li><strong>Fundamental Principle \u2014 Load Management:<\/strong> The tendon needs mechanical load to regenerate (load stimulates tenocytes + collagen synthesis) but overload damages it \u2192 the objective is not complete rest (deleterious) but optimized and progressive loading \u2192 maintain activity within pain limits (pain \u2264 4\/10 during and return to normal within 24 hours)<\/li>\n <li><strong>Acute phase \u2014 reducing the irritant load:<\/strong> Identify and reduce (but not eliminate) aggravating activities \u2192 substitute with low-impact activities for the tendon (cycling + swimming + unloaded exercises) + ice after activity (pain-relieving effect) + paracetamol or short-term NSAIDs (symptomatic relief) + brace or splint if necessary<\/li>\n <li><strong>Eccentric exercises (cornerstone of chronic tendinopathy treatment):<\/strong> muscular contraction during tendon lengthening \u2192 Alfredson's program for the Achilles tendon (200 repetitions\/day \u00d7 3 sets of calf raises \u2192 slow descent over 3 counts) + Stanish's program + pain reduction from 60\u201390 % to 3 months in Achilles and patellar tendinopathies + mechanism: stimulation of collagen synthesis + fiber reorganization + reduction of neovascularization<\/li>\n <li><strong>Isometric exercises (acute phase + reactive tendinopathies):<\/strong> Intense static contraction (70\u201380 % of maximal force) \u00d7 5 repetitions \u00d7 45 seconds \u2192 immediate pain reduction (cortical analogue effect) + no dynamic load on tendon \u2192 useful in the initial painful phase<\/li>\n <li><strong>Isotonic and plyometric exercises (progressive loading phase):<\/strong> Progression from isometric \u2192 slow isotonic \u2192 fast isotonic \u2192 plyometric \u2192 sport-specific activity \u2192 return to sport \u2192 progression must adhere to the absence of residual pain (> 24 hours) before advancing to the next stage<\/li>\n <li><strong>Corticosteroid injections<\/strong> short-term analgesic effect (4\u20138 weeks) + but does not alter long-term progression + repeated infiltrations (\u2265 3) weaken collagen + increase rupture risk \u2192 limit to a maximum of 1\u20132 infiltrations over time + do not infiltrate the body of the Achilles tendon (rupture risk) + associated bursitis may benefit from targeted infiltration<\/li>\n <li><strong>Platelet-rich plasma (PRP):<\/strong> Platelet-rich plasma (PRP) injection (growth factors + PDGF + TGF-\u03b2 + VEGF + IGF) \u2192 stimulation of tendon regeneration + randomized studies: mixed results but positive trend for chronic refractory tendinopathies (epicondylitis + Achilles) + less risk than corticosteroids<\/li>\n <li><strong>Extracorporeal Shockwave Therapy (ESWT)<\/strong> Acoustic microtrauma \u2192 stimulation of vascularization + collagen synthesis + desensitization of nociceptors \u2192 proven efficacy in calcific tendinopathies of the shoulder + epicondylitis + plantar fasciitis + 3\u20135 sessions weekly<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Fluoroquinolones (ciprofloxacin + levofloxacin + moxifloxacin) are associated with a significant risk of tendinopathy and tendon rupture\u2014particularly of the Achilles tendon\u2014up to several months after discontinuation of treatment. The risk is multiplied by 2 to 6 in patients over 60 years of age, those taking corticosteroids, kidney transplant recipients, or those with a history of tendinopathy. Any patient on fluoroquinolone who develops tendon pain should stop the antibiotic and be evaluated. Pain in the Achilles tendon while on fluoroquinolone warrants exclusion of a partial or imminent rupture.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Urgent medical consultation<\/div>\n <p>Consult emergency services immediately if sudden, intense pain accompanied by a \u00abpopping\u00bb sensation in the calf or heel occurs during exertion \u2014 especially in individuals over 40 years old, taking fluoroquinolones, or taking corticosteroids \u2014 as these signs may indicate a complete Achilles tendon rupture (positive Thompson's test = no plantarflexion when the calf is squeezed \u2192 orthopedic surgical emergency). For the assessment and management of chronic tendinopathy, Clinique Omicron offers medical consultations at its service points in Quebec and via telemedicine. To make an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Clinique Omicron's physician associates and nurse practitioners (NPs) diagnose tendinopathies through clinical examination (specific tests based on location), prescribe appropriate imaging assessments (ultrasound + MRI if rupture is suspected), initiate load management, and refer patients to physiotherapy for eccentric exercise and progressive loading programs, prescribe short-term NSAIDs for symptomatic relief, assess the indication for corticosteroid injections or PRP based on the clinical presentation, and screen for systemic contributing factors (diabetes + dyslipidemia + fluoroquinolones). Consultations are available at several service points in Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The content of this page is for informational purposes only and does not substitute medical advice from a doctor, physical therapist, or sports physician. A complete tendon rupture (particularly the Achilles tendon) is an orthopedic emergency. Repeated corticosteroid injections into a tendon weaken collagen and increase the risk of rupture\u2014limit to a maximum of 1-2 injections over the course of tendinopathy.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Tendinite et tendinopathie : diagnostic, traitement et r\u00e9habilitation | Clinique Omicron M\u00e9decine du sport & Orthop\u00e9die & M\u00e9decine de famille Tendinite et tendinopathie Le terme tendinite \u2014 qui implique une inflammation aigu\u00eb du tendon \u2014 a \u00e9t\u00e9 largement supplant\u00e9 dans la litt\u00e9rature m\u00e9dicale moderne par le terme tendinopathie, plus pr\u00e9cis et plus exact sur le… <a href=\"https:\/\/cliniqueomicron.ca\/en\/tendinite\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Tendinitis and Tendinopathy: Diagnosis, Treatment, and Rehabilitation | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Tendinite \/ Tendinopathie | Brossard | Clinique Omicron","_metasync_otto_description":"Tendinite \/ Tendinopathie Tendinite \/ Tendinopathie est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos profess...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Tendinite | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Tendinite \/ Tendinopathie Tendinite \/ Tendinopathie est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos profess...","_metasync_otto_twitter_title":"Tendinite | Clinique Omicron","_metasync_otto_twitter_description":"Tendinite \/ Tendinopathie Tendinite \/ Tendinopathie est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos profess...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Tendinite et tendinopathie : diagnostic, traitement et r\u00e9habilitation | Clinique Omicron","_aioseo_description":"La tendinopathie est une d\u00e9g\u00e9n\u00e9rescence tendineuse chronique avec d\u00e9sorganisation du collag\u00e8ne. Achille rotulien \u00e9picondylite coiffe rotateurs, exercices excentriques Alfredson 200rep\/jour, PRP ondes de choc fluoroquinolones risque rupture au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-10T07:39:06+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-24999","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Tendinite \/ Tendinopathie Tendinite \/ Tendinopathie est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. 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