Sore joints? You may have a form of tendinopathy.

This story first appeared in Healthy You - April 2025, The Gazette’s quarterly health publication.

You don’t need to live with that nagging soreness in a shoulder, elbow or other joint.

“These types of things begin slowly and insidiously and tend to build with chronic overuse,” said Dr. Clay Walker of the Steindler Orthopedic Clinic in Iowa City. “It can start as a nuisance, and you proceed with the activity and it progresses to where you feel it even at rest.”

What many older people may write off as routine “aches and pains” are usually examples of stress or damage to their tendons — the thick, fibrous cords that attach muscle to bone. The resulting soreness, pain and tenderness is referred to as tendinopathy.

The two most common types of tendinopathy are:

“Tendinitis is the acute inflammation of the tendon usually, after an overload injury,” Walker said.

Many specialists view tendinosis “as the end of the spectrum of tendinopathy,” according to Dr. Blake Eyberg, orthopedic specialist with Physicians Clinic of Iowa. “First-time tendinopathy may present as pain, weakness or dysfunction, but may not show any cellular changes to tendinosis. Not all people who have tendinopathy have tendinosis.”

Even tiny movements such as clicking a mouse can cause tendinosis, when done repeatedly.

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“With keyboarding, we see people develop tennis elbow,” Walker said. “That can be corrected with better ergonomics, keyboard set-up and desk height to improve posture. You can develop these types of injuries with similar repetitive motions. It doesn’t have to be long-distance running or weightlifting.”

Identifying such potentially risky practices or habits can keep a person active.

“Prevention is key, because these can take a while to rehab,” Walker said. “If they’re picking up a new activity, ease into it. With runners, we recommend not increasing your distance by more than 10 percent a week. Mix up your exercises — if you’re running, maybe mix in some cross-training exercises, just to get some different loads onto the tendons.”

Older people are more susceptible to chronic injury.

“As we age, our tendons become less flexible and more prone to injury,” Walker said. “Obesity is a risk factor.”

“Age certainly plays a role in tendon health, as does genetics,” Eyberg added. “Tendinosis develops because of a decreased ability to fully heal the tendon after injury. As we get older, our body has a more limited ability to heal tendon injuries, but some people may be more susceptible than others.”

If tendon injury does happen, early detection and diagnosis can lead to successful outcomes.

“Any active individual is going to develop aches and pains through their normal routine,” Walker said. “If it takes a week or two, that’s something that should bring them to a physician.”

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“If you have persistent pain that extends beyond two weeks, make an appointment with your primary-care physician,” Eyberg said. “If your diagnosis is confirmed you will be treated with a course of physical therapy or a home exercise program, anti-inflammatories and possibly offered a cortisone injection.”

Fortunately, simple treatment is usually effective. Eyberg estimates “90 percent of cases of tendinopathy are self-limited and will get better with time,” given rest and recuperative physical therapy.

“That’s when we start getting you involved with physical therapy,” Walker said. “Insoles for runners, shock-wave therapy using acoustic waves to stimulate tissue growth.”

For more serious cases, surgery is an option. Eyberg noted a tendon’s damaged portion may be removed, with the healthy tendon reattached to the bone, although isn’t an effective treatment for shoulder injury.