What are the 4 symptoms of tendonitis?

The four symptoms, taken in the order a session presents them

What are the four symptoms of tendonitis is a question the textbooks answer with a list and a lifter answers with a session, so this page walks the list in the order a training day presents it, because that order is itself the most useful diagnostic. Symptom one, the warm-up pattern: the tendon hurts at the start, the first sets of squats for a patellar tendon, the first minutes of a run for an Achilles, the first presses for a shoulder or the first curls for an outer elbow, and the pain eases as the tissue warms and the session goes on, then returns afterwards, that evening or the next morning, and this pattern of pain that warms out and comes back is the signature of tendon pain, since most joint pain does the opposite and worsens as a session goes on, so a lifter who can describe the warm-up pattern has already told an assessor most of what they need. Symptom two, point tenderness: tendon pain is local, and pressing along the tendon finds one spot under a single fingertip that reproduces it, just below the kneecap at the patellar tendon, a few centimetres above the heel on the Achilles, the bony point of the outer elbow, the front of the shoulder where the long head of the biceps runs, whereas joint pain is usually diffuse and hard to pin with a finger. Symptom three, stiffness after rest: the first steps out of bed in the morning, or standing up after an hour at a desk, bring a stiff, tight tendon that eases within a few minutes of moving, the same warm-up pattern in miniature, and the morning version is often the symptom a lifter notices first and ignores longest. Symptom four, lost capacity: the load, depth, speed or volume the tendon took a month ago now provokes it, the jump that was fine is not, the fifth set is the one that hurts, and sometimes the tendon itself is visibly or palpably thicker than its partner on the other side, which is the tissue's failed-healing change made visible. Four symptoms, and a lifter who has all four has a tendon problem that the loading literature describes as load exceeding the tendon's current capacity, which is why the established management is a progressive loading programme, usually physiotherapist-guided, and not rest.

The two that are not tendonitis, the word itself, and where collagen sits

Two presentations are not these four and the honest page prints them, because a lifter who searches for tendonitis symptoms with one of these has a different problem and a different urgency. The first: a sudden pop or snap, often felt or heard, followed by a gap that can be felt in the tendon, an inability to push off the foot or to straighten the knee against gravity, or a visible change in the muscle's shape, which is the rupture picture and needs assessment the same day, since a ruptured tendon is a surgical or specialist decision and not a rehabilitation programme. The second: a joint that is hot, red and swollen, especially with fever or a general feeling of being unwell, which is not a tendon problem at all and needs urgent assessment, since an infected or acutely inflamed joint is a medical matter with a clock on it. Neither of these is a supplement question and this site says so plainly. Then the word itself, because it misleads treatment: tendonitis means inflammation of a tendon, and the histology of chronic tendon pain, the biopsies from painful Achilles and patellar tendons, shows a degenerative, failed-healing picture, disorganised collagen, increased ground substance, new blood vessels and nerve ingrowth, with little of the inflammatory cell picture the -itis implies, which is why the field now says tendinopathy, why anti-inflammatory approaches and rest do little for the chronic version, and why the established management is progressive load, the eccentric heel-drop tradition for the Achilles and its descendants for every other tendon, guided by pain during and after loading rather than by avoiding it. Where collagen sits in all this is the last paragraph and not the first, and it sits as an adjunct: a small crossover trial found around fifteen grams of gelatin or hydrolysed collagen with roughly 50mg of vitamin C an hour before loading roughly doubled a blood marker of collagen synthesis, the basis of the pre-loading protocol some physiotherapists use alongside the programme, a marker result with no outcome trial and no claim, so collagen does not treat any of the four symptoms and is discussed with the physiotherapist running the loading programme, never bought instead of the assessment. The worked example is stated as the adjunct it is: two capsules, 1200mg hydrolysed type 1 marine collagen with 12mg vitamin C plus zinc, 120 for £16.99 at 28p a day, lab tested and UK made, a dose well below the protocol's fifteen grams and taken for vitamin C's collagen formation sentence, the register's only collagen line, while the protocol lifter buys the grams as gelatin or powder. The four symptoms: the warm-up pattern, the fingertip spot, the morning stiffness and the lost capacity; the two that are not: the pop and the hot joint; and the treatment, a loading programme with an assessment at its start.

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