Pain around your joints may occur for many reasons. One of those reasons can be inflammation or deterioration of a tendon. Tendons are the thick, flexible cords of tissue that attach muscle to bone. One of their key functions is to help muscles move bones.

Tendon issues can commonly occur in the shoulder, bicep, elbow, hand, wrist, thumb, calf, knee, or ankle. Since the pain associated with tendon issues often occurs near a joint, it can sometimes be mistaken for arthritis.

Confusing Terminology

We are the first to admit that the terms used for tendon issues and conditions are confusing. They have similar sounding names which can make sorting through it all baffling. We will provide some clarity for you.

Tendonitis is a condition that is often caused by overuse, leading to inflammation. The result is swelling, pain, and discomfort. Tendonitis by the way is spelled slightly differently by some as tendinitis.

Given that tendonitis is often caused by athletic activity, some forms of it are commonly named after certain sports, such as tennis elbow, golfer’s or baseball elbow, jumper’s knee, pitcher’s shoulder, and swimmer’s shoulder.

Tendinosis is primarily a degradation of tendon tissue, usually without inflammation – although in some cases in may involve inflammation. It is a chronic condition that involves the deterioration of collagen, which is a structural protein in the tendons. It too can be spelled slightly differently by some as tendonosis. And some refer to tendinosis and chronic tendon disease.

Tendonopothy is a general term used to describe any disease or dysfunction involving a tendon. It encompasses both tendonitis and tendinosis as well as longitudinal tendon tears.

Tendonitis versus Tendinosis

Until recently, most tendon injuries were diagnosed as tendonitis. This was because traditional diagnostic imaging such as X-rays and MRIs don’t show tendons in motion. However ultrasound technologies now allow real time imaging of tissues in motion.

Ultrasound allows doctors to distinguish between the inflammation of tendonitis and the degeneration of tendinosis, as well as identify longitudinal tears.

Distinguishing between the two conditions is critical, as tendonitis and tendinosis each reflect a distinctly different condition with a tendon, requiring different treatments.

Treating Tendonitis and Tendinosis

Most cases of tendonitis respond to self-care measures. Your best initial approach is rest and short-term use of over-the-counter anti-inflammatories. Icing the area several times a day may also help.

However if your tendon isn’t better after 6 weeks, you should consult your doctor for a more detailed diagnosis.

If your condition is identified as tendonitis, your doctor may recommend physical therapy and exercises to strengthen the tendons and muscles and preserve your range of motion. They may also determine that a corticosteroid injection may be the right treatment to decrease the inflammation and relieve the condition.

However, if your doctor determines that you have tendinosis and pain persists, other options may be recommended. One option may be PRP therapy which may be effective in stimulating a healing response using an injection of prepared healing factors from your own blood.

Another option may be a minimally invasive, outpatient procedure called ultrasonic percutaneous tenotomy. This procedure uses a thin metal probe that vibrates at 20,000 rpm to gently dissolve and remove damaged tendon tissue.

The good news is that tendonopathy usually responds to nonsurgical care.

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Platelet-Rich Plasma – PRP – often pops up in sports injury news headlines. From what we read, plasma-rich platelet injections are often a well-publicized factor in professional athletes’ treatment and recovery.

These stories stir the imagination of the public at large. If PRP treatment works for our sports heroes, will it work for our own injuries?

The answers to these questions and others are not clear at this point. Doctors are currently using PRP treatments to accelerate the healing process of soft tissues. But it is a therapy still very much in the early stages of development.

Tiger Woods was one of this therapy’s early adopters. We’ll use his example as a starting point in answering “what is PRP therapy.”

Tiger Woods’ Knee Issues

In 2008, Tiger had two major knee surgeries within a span of 10 weeks. The first happened in April of that year when he finished second in the Masters Golf Tournament. Two days later, he had arthroscopic surgery to remove cartilage damage in his left knee.

Shortly after, Tiger competed in the 2008 U.S. Open in June. He played with a torn ACL (anterior cruciate ligament), an injury that dated back to just after the 2007 British Open. He also had leg stress fractures.

Despite those physical challenges, Tiger still won the tournament. But sports commentators at the time noted how much in agony Tiger looked as he hobbled to victory.

Nine days after that U.S. Open victory, Tiger had reconstructive surgery to repair the ACL in his left knee. However, the post-surgery recovery was slower than he had hoped. He was impatient and wanted to get to play again more quickly. So, he looked for a way to accelerate his healing process.

He turned to PRP, then a not widely known therapy. He received 4 PRP injections to his knee ligament. Tiger has since publicly commented that he believes the treatments were vital for his timely return to competitive golf.

Tiger Woods smiling on a golf course.
A happy Tiger Woods walks a golf course.

What Is PRP Therapy?

In the years since Tiger placed his faith in PRP, this therapy has evolved and improved dramatically. The answers to what it is begin by reviewing some fundamental basics.


Plasma is the liquid portion of your whole blood. It includes water and proteins. It allows red blood cells, white blood cells, and platelets to circulate through your body.


Platelets, or thrombocytes, are small, colorless cell fragments. When you cut yourself, platelets help blood clot so that you stop bleeding. They also are critical to your body’s natural healing processes.


PRP stands for platelet-rich plasma. The PRP procedure starts with your doctor drawing your blood. They then process the blood in a centrifuge to separate and concentrate your platelets.

PRP Therapy

PRP therapy involves injecting platelet-rich plasma into injured tendons, ligaments, muscles, or joints to accelerate healing. This injection focuses the natural healing components of platelets on the injury. It enables your doctor to direct biological healing processes where they are most needed.

PRP test tube and platelets illustration.
Centrifugal force is used to separate the components of blood – red blood cells (38-48%), plasma (52-62%), and platelets & leukocytes (<1% of total blood).

What is Platelet-Rich Plasma Used For?

Clinical studies have shown that platelet-rich plasma stimulates and improves the healing process. It is not a magical cure, but it does have a role in minimizing pain and improving function. For those who respond to PRP injections, it can reliably decrease inflammation and promote healing.

Platelet-rich plasma therapy may be appropriate to treat knee, elbow, shoulder, and hip osteoarthritis. It may also help with many overuse sports injuries. It is not suitable for all conditions, however.

Doctors are using PRP procedures for soft tissue injuries where there is a firm scientific rationale and sound medical evidence.

Prospective patients, however, also need to have realistic expectations. For example, platelet-rich plasma injections will not heal a rotator cuff tear without surgery. However, PRP can accelerate recovery after this kind of surgical repair.

If successful, a PRP injection generally results in long-lasting relief compared to a cortisone shot. PRP therapy stimulates injured soft tissue to heal or repair itself. In contrast, cortisone injections relieve inflammation pain without directly promoting any healing or soft-tissue repair.

Final Takeaways

PRP is a promising therapy for soft tissue repair. However, there have yet to be any clear standards that have been established for different available treatments.

There are both beneficial PRP treatments available as well as cases where marketing has gotten ahead of the science. Patients should recognize that it is a procedure still under clinical development.

Medical insurance typically does not cover PRP. The out-of-pocket costs for similar procedures can vary widely across different medical providers.

That all being said, legitimate research on PRP at some of the nation’s top medical institutions is leading to significant progress. PRP is an alternative to consider for accelerated musculoskeletal soft tissue injury recovery by patients who have done adequate due diligence.

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