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July 11th, 2019
A man with an elbow injury

Tendinitis and tendinosis are very common conditions we treat in the clinic.

These include common conditions such as:

  • Patellar Tendinitis (jumper’s knee)
  • Achilles Tendinitis
  • Common Flexor Tendinitis (tennis elbow)
  • Common Extensor Tendinitis (golfer’s elbow)
  • Rotator cuff Tendinitis (impingement syndrome)


What is the difference between a tendon and a ligament?

Tendons are the thick fibrous cords that attach muscle to bone, as shown in the picture below.

Drawing of the connection of bones with muscle

Ligaments are the thick fibrous cords that attached bone to bone, as shown in the picture below.

Drawing showing tendons in the hip

Think of both tendons and ligaments is as large cable cords composed of many smaller individual units, which in combination have a lot of strength.

What is the difference between tendinitis and tendinosis?

Tendinitis is an acute injury that results from microtears of the tendon, usually it is because of an injury that causes the tendon to stretch beyond its normal range, causing inflammation, pain and swelling.

Drawing of the connection of bones with muscle

In contrast, tendinosis is a chronic condition. When you have repetitive overuse injuries and microtears, without giving the tendon enough time to rest and heal. Overtime, the actual integrity of the tendon fibers change and instead of normal healing, you get scar tissue formation within the tendon, also weakening the tendon. This is much more difficult to heal. Many acute episodes of tendinitis will eventually cause tendinosis.

Why does it take a long time for tendons to heal?

The problem that exists with both tendons and ligaments is they that have a poor blood supply. As a result, it is difficult to bring in the necessary nutrients to the site of injury for the repair mechanism to take place. This is why it takes a long time for tendons and ligaments to heal after injury.

This is also why treatments like Platelet Rich Plasma therapy (PRP) help augment the healing process by bringing the platelets and growth factors exactly to the site of healing. PRP is being more commonly used than the traditional Steroid (Cortisone shot) as it helps heal and repair the tendon rather than just mask the pain.

In addition, steroids end up weakening the tendon in the long term. More and more studies https://advheal.com/resources/ are showing evidence of PRP becoming one of the main conservative treatment for tendinopathies.

Finally, newer agent such as AmnioFix, which are placental derived growth factors containing over 200 growth factors, are being used more often with good results. We are now using AmnioFix for tougher cases for chronic tendinosis/tendinopathy and even partial tendon tears.

All the procedures are performed under ultrasound guidance so that the treating agent, whether PRP, Amniofix or other biologics, is delivered to the exact site of tendon injury to have the maximum effect.

The most important lesson to be learned is that tendinitis and tendinosis needs to be treated sooner than later. Persistent tendon inflammation and overuse will lead to continued weakening of the tendon and possible tear, making the treatment options become more limited. Surgery is the last option in the most severe cases but can avoided in the majority of cases.

Posted on behalf of Advanced Healing Institute

22972 El Toro Road
Lake Forest, CA, 92630

Phone: (949) 239-3206

Our Patient Reviews

Advanced Healing Institute

5 / 5.0

Based on 39 reviews

Rich G.

Dr. Reza is a genius. My knee has been bothering me for YEARS since I tore my meniscus playing football. Achy, bothersome, with occasionally a limp. I went in to to get PRP (Platelet Rich Plasma) and it was everything I thought it would be and then some. The whole procedure took less than an hour, very little to no pain and in less than 24 hours my knee felt brand new. If you are looking for a quality Doctor who offers PRP -- go here! The rates are very on point. He is literally THOUSANDS of dollars less than some other clinics and believe me he does such an amazing job, he could charge 10x's and it would still be worth it. Don't sit there suffering, get up and get help. I am actually thinking of getting my other knee done and its not really necessary. Lol.. 10 STARS...

E Y.

Dr Reza is FANTASTIC. Staff is friendly and very accommodating. I was in such pain. He diagnosed the issue (Bursitis) and clearly understood everything about it from A-Z. So efficient and understanding, not to mention making the procedure painless. I barely slept a hour the night before, saw Dr. Reza at 5pm and was feeling a million times better by 7pm. It's been 36 hours and I went from practically a frozen shoulder in pulsating pain to gaining back 70% of my movement range and most importantly "NO PAIN". just stiffness which is the normal symptoms as kindly explained to me by Dr. Reza. Everything is as promised, I am fully confident that I will be back to 100% range of motion within 3 days. I'm still gonna take it easy and slowly stretch my shoulder back to full strength. Without his service, I would probably be feeling like I was hit by a truck laying in bed miserable. Thank you very much Dr. Reza for helping my aging old bones. Cheers!

Geri C.

I can’t say enough about how intelligent Dr. Reza Dehdari is! I came to him to read my MRI for my ankle and he found a tear that multiple Doctors missed!!!! Simply incredible and I trust him throughly. Thank you so much!

Marina S.

Had the PRP procedure and I have to say no pain at all, going on 6 weeks, if you decide to have the PRP listen to Dr. Dehdari's instructions thoroughly and do the physical therapy, it works and I am so pleased and it's getting better and better as days go on, Dr. Reza Dehdari is the best and very emphatic in explaining all your questions soothing away your doubts, and he checks up on you to make sure all is well, after the PRP procedure. Very trustworthy PRP procedure and his assistant Sandy is also the sweetest caring person you will ever meet. I'm a satisfied customer and patient.

Micheal W.

Dr. Reza Dehdari you are an amazing person. Thank you for going the extra mile on my shoulder after three Doctors told me I needed surgery. You took your time and explained everything about what to expect and to be patient while I heal. And that’s exactly what I did was heal, I can’t thank you enough for what you did for me.

Helena L.

Within the last 6 months I've suffered two minor injuries on the same knee which have restricted my mobility and caused me a lot of pain. I've seen an orthopedic dr.,, a pain management dr., and a sports medicine dr., all of which simply told me either surgery or learn to live with the pain! I've heard about PRP as an alternative with a high percentage of success. Thus, I made an appointment to see Dr. Dehdari, and was pleasantly surprised by his high level of knowledge, professionalism and thoroughness. Dr. Dehdari reviewed my MRI (previously ordered by the Orthopedist) explained the extent of my injuries, took X-Rays and an ultrasound to carefully determined if I was a good candidate for PRP. I can only say that I wish more doctors will give you the time, attention and care that Dr. Dehdari provides. Thank you Dr Dehdari, thank you for such high work ethics and patient care. Many thanks to his staff as they are as attentive and caring as Dr. Dehdari. It has been only 24 hrs since I received my PRP treatment and my pain levels have drastically gone down! I highly recommend Dr. Dehdari.

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