Tendinopathy & Tenosynovitis – Tendon Pain Treatment in Bromley

Understanding Tendon Pain

Tendon pain is one of the most common causes of ongoing joint and muscle problems. It can limit your movement, affect your sport, and stop you from enjoying daily activities.

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At Bromley Sports Injury Clinic, we specialise in diagnosing and treating tendinopathies and tenosynovitis — from Achilles tendinopathy and jumper’s knee to tennis elbow, shoulder tendinopathy, and wrist pain.

Using advanced musculoskeletal ultrasound and elastography, we can see exactly what is happening inside your tendon. Combined with blood tests to check underlying health factors, this allows us to create a personalised rehabilitation plan that removes the guesswork and accelerates recovery.

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What Are Tendons and Tendon Injuries?

Tendons connect muscles to bones, helping you generate movement. They are tough, flexible, and load-bearing — but they can become injured or irritated through overuse, poor biomechanics, or ageing.

Some tendons are surrounded by a protective layer called a synovial sheath. When this becomes inflamed, it is known as tenosynovitis.

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Types of Tendinopathy & Tenosynovitis

• Tendinopathy – a broad term for pain or dysfunction in a tendon. Includes:

  • Tendinitis – short-term inflammation.

  • Tendinosis – chronic, degenerative change.

  • Calcific tendinopathy – calcium deposits inside the tendon, often in the shoulder.

  • Degenerative tendinopathy – long-standing damage with reduced tendon strength.

• Tenosynovitis – inflammation of the fluid-filled sheath around a tendon. Common in the hands, wrist, feet, or ankles, causing pain, swelling, and sometimes a creaking/grating sensation.

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Common Tendon Conditions We Treat

• Achilles tendinopathy

• Rotator cuff tendinopathy (shoulder)

• Tennis elbow / Golfer’s elbow

• Patellar tendinopathy (jumper’s knee)

• Biceps tendinopathy

• Gluteal tendinopathy

• Calcific shoulder tendinopathy

• De Quervain’s tenosynovitis (thumb/wrist)

• Extensor and flexor tenosynovitis (wrist/hand)

• Posterior tibial or peroneal tenosynovitis (ankle)

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The Tendinopathy Continuum (Cook & Purdam Model)

Modern research shows tendon pain is rarely just “inflammation.” Instead, tendons often follow a progression:

1. Reactive Tendinopathy – early overload, tendon thickening, pain. Often reversible with rest and load management.

2. Tendon Disrepair – structural breakdown begins, tissue disorganisation, nerve and vessel growth. Detectable on ultrasound and elastography.

3. Degenerative Tendinopathy – long-standing tendon pain with disorganised tissue, thickening, or partial tears. Changes may be permanent, but symptoms can still be managed.

By combining diagnostic ultrasound and elastography, we can identify where you are on this continuum and tailor treatment accordingly.

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How Ultrasound & Elastography Help

• Ultrasound provides real-time imaging of tendon structure, fibre alignment, inflammation, calcification, or small tears.

• Elastography measures tendon stiffness and elasticity, helping us:

  • Detect degeneration or scarring.

  • Track tendon healing.

  • Adjust rehabilitation based on actual tissue condition.

This ensures your treatment plan is based on objective findings, not guesswork.

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Blood Tests & Tendon Health

Emerging evidence links metabolic health with tendon injury. For example, high cholesterol and triglycerides (hyperlipidaemia) are associated with tendinopathy in the Achilles, rotator cuff, and patellar tendons.

At Bromley Sports Injury Clinic, we offer blood testing to screen for risk factors such as:

• Dyslipidaemia (high cholesterol/triglycerides)

• Diabetes

• Vitamin D deficiency

• Thyroid imbalance

By identifying these contributors, we can build a more targeted rehabilitation plan and, if necessary, work alongside your GP or specialist for further management.

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Treatment Options for Tendinopathy & Tenosynovitis

✅ Osteopathic treatment – joint mobilisation, soft tissue therapy, and tendon unloading

✅ Exercise rehabilitation – isometric, eccentric, and progressive loading tailored to your tendon stage

✅ Sports massage – reducing muscle tightness in surrounding areas

✅ Ultrasound-guided therapies – including Ostenil® injections or aspiration for calcific tendinopathy

✅ Shockwave therapy – where clinically appropriate

✅ Dry needling – to stimulate tendon healing

✅ Splinting or bracing – for thumb/wrist tenosynovitis

✅ Blood testing & health review – to address systemic factors that delay recovery

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FAQs – Tendinopathy & Tenosynovitis

Q: Can ultrasound diagnose tendon injuries?
Yes. Ultrasound is excellent for detecting tendon thickening, degeneration, tears, calcification, and sheath inflammation.

Q: Do all tendon pains need a scan?
Not always. But if symptoms persist for more than a few weeks, or rehab hasn’t helped, a scan provides vital clarity.

Q: What is calcific tendinopathy?
Calcium deposits within the tendon, often in the shoulder. It can cause severe pain and stiffness, and is easily identified with ultrasound.

Q: Can tendons fully heal?
Many tendons recover with graded loading and rehab. Degenerative changes may not fully reverse, but symptoms can still be controlled effectively.

Q: Why are blood tests relevant?
Because metabolic health (cholesterol, diabetes, thyroid, vitamin D) plays a role in tendon resilience and healing.

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Book Your Appointment

Don’t let tendon pain hold you back. Book your Tendinopathy & Tenosynovitis assessment in Bromley today and start your personalised recovery plan.

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📍 Bromley Sports Injury Clinic | Same-week appointments available