Tendinopathy & Bursitis

Stubborn tendon or “bursitis” pain that just won’t quit.

A sore Achilles that keeps flaring when you walk or run. A hip you can’t lie on. A kneecap that hates squats and stairs. A shoulder that aches every time you reach overhead or sleep on your side.

A lot of these problems are some mix of tendinopathy (tendon overload/change) and bursitis (irritation of a small fluid-filled cushion).

At Timpanogos Physical Therapy, we work with these issues every day. We use a combination of:

• Shockwave therapy – one of our most potent tools for chronic tendon and bursa-related pain
• Electromagnetic therapy (EMTT) – an emerging technique showing promising results for stubborn tendon problems
• Targeted strengthening and loading programs
• Manual therapy
• Red / near-infrared light therapy

To help irritated tissues calm down, remodel, and return to everyday life and sports.

Common tendinopathy & bursitis problems we treat

We see a lot of:

• Achilles tendinopathy and retrocalcaneal bursitis
• Patellar and quadriceps tendinopathy (“jumper’s knee”) and pes anserine bursitis
• Gluteal tendinopathy and greater trochanteric bursitis (outer hip pain, often at night or with standing/walking)
• Rotator cuff tendinopathy and subacromial/subdeltoid bursitis (painful arc, reaching, sleeping on that shoulder)
• Lateral and medial elbow tendinopathy (tennis/golfer’s elbow)
• Tibialis posterior/anterior and peroneal tendinopathy around the ankle and foot

Sometimes you’ve been told it’s “just bursitis.” Sometimes it’s “just tendonitis.” Often it’s a bit of both—and that’s okay. We treat the whole picture, not just the label.

What’s going on with tendinopathy?

With tendinopathy, tendons:

• Have been overloaded repeatedly beyond what they were ready for
• Become thicker, more sensitive, and less efficient at handling force
• Often develop hot spots that hurt with particular activities—stairs, running, gripping, squatting, etc.

This is why total rest usually doesn’t fix it long term. The tendon may be quieter for a while, but it doesn’t learn to handle load any better, and the same issue comes back when you ramp up again.

What’s going on with bursitis?

A bursa is a small fluid-filled sac that helps things glide smoothly—like tendons over bone. When it gets irritated, you may feel:

• Localized ache or sharp pain over a bony spot (outer hip, side of shoulder, inside of knee)
• More pain with pressure (lying on that side, leaning on that elbow)
• More pain with certain motions where the tendon and bursa are getting compressed together

Bursitis is rarely isolated. It’s often driven by:

• Tendon overload or weakness nearby
• Movement patterns that keep pinching or compressing the same spot
• Changes in posture, strength, or activity over time

So for bursitis, we don’t just chase inflammation. We look at the tendon, the muscle, the joint, and the way you move.

Why “rest and anti-inflammatories” often fall short

You might have already tried:

• Rest
• Ice
• A brace or strap
• Medication
• Maybe even a cortisone shot

Those may temporarily quiet symptoms, but they don’t:

• Restore tendon capacity
• Address how you load the area
• Change the way joints and muscles share the work

That’s where shockwave, EMTT, and a focused loading plan make a big difference.

Shockwave therapy: a significant tool for tendon & bursitis pain

For persistent tendon and bursa-related pain, shockwave therapy is one of our go-to treatments.

Shockwave uses targeted mechanical pulses to:

• Reduce pain and sensitivity in irritated tendons and surrounding tissues
• Support circulation and cellular activity in the area
• Promote tissue remodeling so tendons and nearby structures tolerate load better

We use it frequently for:

• Patellar and quadriceps tendinopathy/pes bursitis
• Achilles tendinopathy
• Gluteal tendinopathy and trochanteric bursitis
• Rotator cuff tendinopathy and subacromial bursitis
• Tennis and golfer’s elbow

Shockwave is especially helpful when:

• Pain has been around for months or years
• You’ve already tried basic PT, rest, or medications
• The tendon or bursa seems “stuck” in the same painful pattern

On its own, it’s powerful. Combined with smart strengthening and load management, it’s often a turning point for people who’ve been stuck for a long time.

EMTT: an emerging, promising option

Electromagnetic therapy (EMTT) uses high-energy, pulsed magnetic fields around the affected area.

For tendinopathy and bursitis, EMTT aims to:

• Influence the cellular environment around the tendon and bursa
• Support local circulation and metabolism
• Help surrounding muscles relax and move more normally

EMTT is an emerging therapy—the research is growing, and early evidence plus our clinical experience suggest it can be beneficial when:

• Tendon pain has been long-standing and complicated to change
• There’s a lot of muscle guarding around the painful area
• We’re pairing it with shockwave and a progressive loading plan

We’ll always be upfront: Shockwave has the stronger evidence base right now; EMTT is a promising add-on that can further support recovery in the right cases.

The other half: loading the tendon (and protecting the bursa)

Even with great tools, tendons won’t rebuild themselves without load. And bursae won’t calm down if we keep pinching them the same way.

Your plan will usually include:

• Isometric exercises early on to reduce pain and gently load the tendon
• Eccentric and heavy-slow strengthening as you’re ready, to rebuild tendon capacity truly
• Adjusting angles and ranges of motion to avoid excessive compression on an irritated bursa while it calms down
  
  
• Strengthening the whole chain—hip, core, shoulder blade, foot/ankle, etc.—so the painful area isn’t doing extra work
• Gradual return to impact, speed, and sport-specific activities if that’s your goal

We’ll give you clear progressions, not just a list of random exercises.

What a typical plan may include

Every case is different, but many tendinopathy/bursitis plans at Timpanogos PT use some mix of:

1. Thorough evaluation

We identify:

• Which tendon(s) and bursa(e) are involved
• What movements and loads aggravate them
• Gaps in strength, mobility, and control up and down the chain
• Your goals—work, daily life, hobbies, or sport

2. Shockwave therapy

Used to:

• Target stubborn hotspots in the tendon and surrounding tissue
• Help long-irritated areas start moving in the right direction
• Make progressive strengthening more tolerable and effective

3. EMTT (Electromagnetic therapy)

Added when appropriate to:

• Support the tissue environment around the tendon and bursa
• Reduce muscle guarding and sensitivity
• Complement the effects of shockwave and active rehab

4. Manual therapy

Hands-on care may involve:

• Joint mobilization above and below the painful area
• Soft-tissue work to muscles and fascia that are overloaded
• Techniques to help the region move more freely and comfortably

5. Progressive loading & movement training

We guide you through:

• Pain-tolerant early loading
• Smart progression in strength, range, and intensity
• Movement and technique tweaks for walking, lifting, running, or sports

6. Red & Near-Infrared Light Therapy

We may add red / near-infrared light to:

• Support recovery between sessions
• Help manage post-treatment soreness
• Promote tissue health without adding more mechanical stress

What progress can look like

Over time, people with tendinopathy and bursitis often notice:

• Less aching at rest and less “throb” at night
• Easier time lying on the affected side (hip/shoulder)
• Climbing stairs, walking, or running with fewer sharp reminders
• More tolerance for lifting, gripping, squatting, or overhead work
• Feeling like the area is reliable again, not always on the edge of flaring

It’s usually a gradual change, but with the right mix of shockwave, EMTT, hands-on care, and progressive loading, that stubborn tendon or “bursitis” doesn’t have to stay stubborn forever.

FAQs

Is this just inflammation?
 Not usually. Tendinopathy involves changes in tendon structure and its load-handling properties. Bursitis can have an inflammatory component, but it’s often driven by how tendons, joints, and movement patterns are behaving around it.

Do I need to stop all activity?
 Typically, no. We’ll adjust what you do and how much, but keeping some level of activity—within reason—is usually better than complete rest.

Do I need imaging first?
 Often, no. Many tendinopathy and bursitis issues can be diagnosed with a good exam. If we see signs of a tear, major structural problem, or something that would change the plan, we’ll talk through whether imaging makes sense.

How long does it take to feel better?
 It depends on how long it’s been going on and how irritable things are. Many people notice changes in the first few weeks as we use tools like Shockwave and start bright loading, with bigger gains over a few months as strength and tolerance build.

Ready for that “same old tendon/bursitis” to start moving in the right direction?

If you’ve had tendon or bursitis pain hanging around for months—or you keep getting the same diagnosis without real change—there’s a more complete way to approach it.

Schedule an evaluation with Timpanogos Physical Therapy, and we’ll build a plan that combines powerful tools—like shockwave and EMTT—with bright, progressive loading so your tendon and bursa have a real chance to calm down, remodel, and get back to your life.