What Is Tendinitis?
Tendinitis refers to inflammatory conditions affecting the tendons, the fibrous structures that connect muscles to bones and transmit the forces required for movement. It usually develops as a result of repetitive strain, sudden overloading or an accumulation of micro-injuries over time without sufficient recovery.
It is one of the most common musculoskeletal conditions, affecting both the general population and athletes. Typical examples include lateral epicondylitis, commonly known as tennis elbow, Achilles tendinitis, shoulder periarthritis and patellar tendinitis.
Characteristic symptoms include localised pain during movement or palpation, swelling, stiffness and, in some cases, a grating or creaking sensation.
The pain often worsens at the beginning of movement, improves after sufficient warm-up and then returns once the activity has ended.
Inflammation in Tendinitis
In tendinitis, inflammation is mainly located in the paratenon, the connective tissue surrounding the tendon, although it may also extend into the tendon itself. In chronic cases, repeated inflammation can lead to structural changes, including calcium deposits, fibrotic thickening and microtears that weaken the tendon.
A key characteristic of tendons is their naturally limited vascular supply, meaning that they receive less blood than many other soft tissues.
As a result, their natural capacity for repair is limited, and chronic tendinitis may persist for months or even years when it is not managed appropriately.
The condition does not affect only high-performance athletes. People whose work involves repetitive movements, including office workers, construction workers and healthcare professionals, also experience high rates of tendinitis.
Scientific Research
Scientific research has focused on the role of neovascularisation and cellular renewal in tendon repair. Animal studies and clinical research have shown that increased local oxygenation can activate tenocytes, the specialised cells responsible for producing and maintaining the tendon’s collagen structure.
Particularly in chronic tendinitis with degenerative changes, improved vascularisation appears to be an important prerequisite for breaking the cycle of repeated tissue injury.
Clinical reports evaluating hyperbaric oxygen therapy as an adjunctive treatment for persistent tendinitis have documented reductions in pain and improvements in function, particularly among patients who did not respond adequately to conservative treatment.
Hyperbaric Oxygen Therapy for Tendinitis
Hyperbaric oxygen therapy does not replace physiotherapy, rest or local anti-inflammatory treatment. It may be incorporated as an adjunctive option, particularly in chronic or recurrent cases of tendinitis that do not respond to standard management.
Its primary mechanism of action is the improvement of oxygenation within poorly vascularised tendon tissue. The high partial pressure of oxygen achieved inside the chamber allows oxygen carried in the plasma to diffuse more deeply into the tissue, even where the capillary supply is insufficient.
This local hyperoxygenation activates tenocytes, promotes the synthesis of type I collagen—the principal structural component of tendons—and reduces chronic inflammatory activity. At the same time, the resulting neovascularisation may improve blood supply to the affected area over the longer term and reduce the risk of recurrence.
The treatment course is tailored to the duration and severity of the condition and typically consists of 15 to 30 sessions. Hyperbaric oxygen therapy is planned in collaboration with a physical and rehabilitation medicine specialist or orthopaedic surgeon as part of a comprehensive rehabilitation programme.