Table of ContentsView AllTable of ContentsR.I.C.E.ExerciseMassageAcupunctureSupplementsDiet
Table of ContentsView All
View All
Table of Contents
R.I.C.E.
Exercise
Massage
Acupuncture
Supplements
Diet
The R.I.C.E. protocol (rest, ice, compression, and elevation) is a common natural remedy for tendonitis, an injury to a tendon that’s often due to repetitive strain. Other natural remedies may include alternative medicine options like acupuncture, herbal remedies, and massage.
Keep in mind that natural remedies fortendonitisshow some promise, but there’s limited scientific support for the claim that any form of alternative medicine can treat the condition. More research is needed.Talk with your healthcare provider about natural remedy use.
Image Source/Getty Images
1. R.I.C.E. Protocol
The R.I.C.E. method can be used to treat pain and swelling from tendonitis right away. It involves:
The R.I.C.E. option is not the only method, and some experts recommend other approaches to ensure that blood flow is available to help promote healing.
2. Exercise and Physical Therapy
While resting is important immediately after a sudden injury, most people diagnosed with a tendon injury benefit from gentle exercises once their healthcare provider says it’s okay.
Exercise is the first-line treatment strategy of a conservative approach to tendonitis that typically affects:
A 2023 review of resistance training exercises looked at 110 different studies on how the exercises were used to treat tendonitis at common sites. They included the intensity and frequency of different exercise types, as well as which types were preferred for knees, hips, etc.
The exercise types included:
Each type of exercise focuses on how your muscles contract and the specific benefits. The authors note that the shoulder and the Achilles tendon in your foot, for example, perform very different tasks in daily life. Therefore, the same type and intensity of exercises may not work for all cases.
Physical therapycan benefit those with injuries that need treatment from a healthcare provider. A physical therapist will focus on providing the right stretches and exercises to help you heal an injury.
Who’s At Risk for Tendonitis?Tendonitis is an inflammation of tissue that attaches muscles to bone. It most commonly occurs around the elbows, shoulders, and knees, but it can also affect the wrists, hips, and heels. Sports injuries and repetitive motion injuries, often work-related, are common causes of a tendon injury. Older people are more likely to injure a tendon than younger people. A 2023 study found that smoking and alcohol consumption can affect whether surgery is needed or, as in 90% of cases, if treatments like exercise will manage tendonitis.
Who’s At Risk for Tendonitis?
Tendonitis is an inflammation of tissue that attaches muscles to bone. It most commonly occurs around the elbows, shoulders, and knees, but it can also affect the wrists, hips, and heels. Sports injuries and repetitive motion injuries, often work-related, are common causes of a tendon injury. Older people are more likely to injure a tendon than younger people. A 2023 study found that smoking and alcohol consumption can affect whether surgery is needed or, as in 90% of cases, if treatments like exercise will manage tendonitis.
3. Massage for Tendonitis
Some studies have shown that massage works for pain relief. Others find less evidence for massage and greater improvements with treatments like extracorporeal shockwave therapy (ESWT). It’s also noted that ESWT is similar to massage in the way sound and vibration affect tissue.
If you want to try massage, there are a few types available:
Risks of Massage TherapyThere are few risks to having massage therapy, although there have been isolated reports of blood clots, bone fractures, or nerve injury.This may be more common in older adults or people with underlying medical conditions like cancer,osteoporosis, or deep vein thrombosis. Talk with your healthcare provider about the treatment and a referral to a licensed massage therapist.
Risks of Massage Therapy
There are few risks to having massage therapy, although there have been isolated reports of blood clots, bone fractures, or nerve injury.This may be more common in older adults or people with underlying medical conditions like cancer,osteoporosis, or deep vein thrombosis. Talk with your healthcare provider about the treatment and a referral to a licensed massage therapist.
4. Acupuncture
Acupuncture is, like Tuina, based on TCM principles. It has been shown to improve blood flow and the delivery of oxygen to tissues in the tendon. It also may play a role in nerve function.
Be sure to speak with your healthcare provider before trying acupuncture. It does have somepotential side effectsand may not be safe for everyone.
5. Vitamins, Supplements, and Herbs
There is interest and some evidence for how vitamins, supplements, and herbal products can be used as natural remedies for tendonitis.
Herbal Products
Vitamin Supplements
Vitamin supplements have been studied for their effects in treating tendonitis. Vitamins and minerals that may play a role in tendon health include vitamin C.
However, many other minerals and supplements are under study, includingcollagensupplements,chondroitin,omega-3 fatty acids, and even post-surgery healing patches that contain zinc.
6. Foods and Diet
The relationship between diet and any impact on tendonitis remains unclear. A 2019 study of high-level athletes and the Achilles tendon looked at water intake, diet, and exercise to determine the effects on the tendon.
The only nutrition-related trend appeared in people with Western-style diets (increased meat, fats, processed foods) consumed during their youth.That said, it’s important to maintain a well-balanced diet. It’s also important to maintain a healthy weight in order to protect joints and muscles.
Summary
Tendonitis may require more comprehensive treatment from a healthcare provider, but many people can resolve the pain and inflammation with conservative measures. These natural remedies can include immediate rest and icing of a sudden injury or alternative options like acupuncture.
Talk to your healthcare provider about tendonitis treatment. Even simple measures like taking a vitamin or supplement may be a concern if you have another health condition or take other medications. It’s also likely that you may need additional care from a healthcare provider.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Loiacono C, Palermi S, Massa B, et al.Tendinopathy: Pathophysiology, therapeutic options, and role of nutraceutics. A narrative literature review.Medicina (Kaunas). 2019;55(8):447. doi:10.3390/medicina55080447American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Singh DP, Barani Lonbani Z, Woodruff MA, Parker TJ, Steck R, Peake JM.Effects of topical icing on inflammation, angiogenesis, revascularization, and myofiber regeneration in skeletal muscle following contusion injury. Front Physiol. 2017;8:236597.Pavlova AV, Shim JSC, Moss R, Maclean C, Brandie D, Mitchell L,et al.Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis.Br J Sports Med. 2023 Oct;57(20):1327-1334. doi:10.1136/bjsports-2022-105754Zhang C, Jia Z, Li J, Wang X, Yang S.Impact of lifestyle and clinical factors on the prognosis of tennis elbow.Sci Rep. 2024 Feb 6;14(1):3063. doi:10.1038/s41598-024-53669-xÇetin BV, Sepetçi Ö, Yazar İ, Kaptan AY, Orhan Ö, Demir M,et al.Comparison of local massage, steroid injection, and extracorporeal shock wave therapy efficacy in the treatment of lateral epicondylitis.Jt Dis Relat Surg. 2024 Apr 26;35(2):386-395. doi:10.52312/jdrs.2024.1648Ragone F, Pérez-Guillén S, Carrasco-Uribarren A, Cabanillas-Barea S, Ceballos-Laita L, Rodríguez-Rubio PR,et al.The Effects of Soft-Tissue Techniques and Exercise in the Treatment of Patellar Tendinopathy-Systematic Review and Meta-Analysis.Healthcare (Basel).2024 Feb 7;12(4):427. doi:10.3390/healthcare12040427Yang J, Zhou X, Ma Q, Woods JT, Mohabbat AB, Do A,et al.Efficacy and safety of Tuina for chronic nonspecific low back pain: A PRISMA-compliant systematic review and meta-analysis.Medicine (Baltimore). 2023 Mar 3;102(9):e33018. doi:10.1097/MD.0000000000033018Guo M, Zhang M, Guo X, Wang H, Li H.Acupuncture combined with Tuina in the treatment of cervical longus tendinitis: A case report.Medicine (Baltimore). 2023 Nov 17;102(46):e35980. doi:10.1097/MD.0000000000035980National Center for Complementary and Integrative Health.Massage therapy: What you need to know.Kubo K, Yasuda A, Yajima H, Takayama M, Takakura N.Effects of acupuncture and acupressure of the acupoint compared to the tendon on the blood circulation of human tendon in vivo.Eur J Appl Physiol. 2024 Jan;124(1):269-279. doi:10.1007/s00421-023-05277-2Stoychev V, Finestone AS, Kalichman L.Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review.Curr Rev Musculoskelet Med. 2020 Feb;13(1):133-140. doi:10.1007/s12178-020-09608-0.Fusini F, Bisicchia S, Bottegoni C, Gigante A, Zanchini F, Busilacchi A.Nutraceutical supplement in the management of tendinopathies: a systematic review.Muscles Ligaments Tendons J. 2016 May 19;6(1):48-57. doi:10.11138/mltj/2016.6.1.048Noriega-González DC, Drobnic F, Caballero-García A, Roche E, Perez-Valdecantos D, Córdova A.Effect of vitamin C on tendinopathy recovery: A scoping review.Nutrients. 2022 Jun 27;14(13):2663. doi:10.3390/nu14132663Zhang Q, Yang Y, Suo D, Zhao S, Cheung JC, Leung PH,et al.A Biomimetic Adhesive and Robust Janus Patch with Anti-Oxidative, Anti-Inflammatory, and Anti-Bacterial Activities for Tendon Repair.ACS Nano. 2023 Sep 12;17(17):16798-16816. doi: 10.1021/acsnano.3c03556.Burton I, McCormack A.Nutritional Supplements in the Clinical Management of Tendinopathy: A Scoping Review.J Sport Rehabil. 2023 May 5;32(5):493-504. doi:10.1123/jsr.2022-0244.Hjerrild JN, Wobbe A, Stausholm MB, Larsen AE, Josefsen CO, Malmgaard-Clausen NM,et al.Effects of long-term physical activity and diet on skin glycation and Achilles tendon structure.Nutrients. 2019 Jun 22;11(6):1409. doi:10.3390/nu11061409
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Loiacono C, Palermi S, Massa B, et al.Tendinopathy: Pathophysiology, therapeutic options, and role of nutraceutics. A narrative literature review.Medicina (Kaunas). 2019;55(8):447. doi:10.3390/medicina55080447American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Singh DP, Barani Lonbani Z, Woodruff MA, Parker TJ, Steck R, Peake JM.Effects of topical icing on inflammation, angiogenesis, revascularization, and myofiber regeneration in skeletal muscle following contusion injury. Front Physiol. 2017;8:236597.Pavlova AV, Shim JSC, Moss R, Maclean C, Brandie D, Mitchell L,et al.Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis.Br J Sports Med. 2023 Oct;57(20):1327-1334. doi:10.1136/bjsports-2022-105754Zhang C, Jia Z, Li J, Wang X, Yang S.Impact of lifestyle and clinical factors on the prognosis of tennis elbow.Sci Rep. 2024 Feb 6;14(1):3063. doi:10.1038/s41598-024-53669-xÇetin BV, Sepetçi Ö, Yazar İ, Kaptan AY, Orhan Ö, Demir M,et al.Comparison of local massage, steroid injection, and extracorporeal shock wave therapy efficacy in the treatment of lateral epicondylitis.Jt Dis Relat Surg. 2024 Apr 26;35(2):386-395. doi:10.52312/jdrs.2024.1648Ragone F, Pérez-Guillén S, Carrasco-Uribarren A, Cabanillas-Barea S, Ceballos-Laita L, Rodríguez-Rubio PR,et al.The Effects of Soft-Tissue Techniques and Exercise in the Treatment of Patellar Tendinopathy-Systematic Review and Meta-Analysis.Healthcare (Basel).2024 Feb 7;12(4):427. doi:10.3390/healthcare12040427Yang J, Zhou X, Ma Q, Woods JT, Mohabbat AB, Do A,et al.Efficacy and safety of Tuina for chronic nonspecific low back pain: A PRISMA-compliant systematic review and meta-analysis.Medicine (Baltimore). 2023 Mar 3;102(9):e33018. doi:10.1097/MD.0000000000033018Guo M, Zhang M, Guo X, Wang H, Li H.Acupuncture combined with Tuina in the treatment of cervical longus tendinitis: A case report.Medicine (Baltimore). 2023 Nov 17;102(46):e35980. doi:10.1097/MD.0000000000035980National Center for Complementary and Integrative Health.Massage therapy: What you need to know.Kubo K, Yasuda A, Yajima H, Takayama M, Takakura N.Effects of acupuncture and acupressure of the acupoint compared to the tendon on the blood circulation of human tendon in vivo.Eur J Appl Physiol. 2024 Jan;124(1):269-279. doi:10.1007/s00421-023-05277-2Stoychev V, Finestone AS, Kalichman L.Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review.Curr Rev Musculoskelet Med. 2020 Feb;13(1):133-140. doi:10.1007/s12178-020-09608-0.Fusini F, Bisicchia S, Bottegoni C, Gigante A, Zanchini F, Busilacchi A.Nutraceutical supplement in the management of tendinopathies: a systematic review.Muscles Ligaments Tendons J. 2016 May 19;6(1):48-57. doi:10.11138/mltj/2016.6.1.048Noriega-González DC, Drobnic F, Caballero-García A, Roche E, Perez-Valdecantos D, Córdova A.Effect of vitamin C on tendinopathy recovery: A scoping review.Nutrients. 2022 Jun 27;14(13):2663. doi:10.3390/nu14132663Zhang Q, Yang Y, Suo D, Zhao S, Cheung JC, Leung PH,et al.A Biomimetic Adhesive and Robust Janus Patch with Anti-Oxidative, Anti-Inflammatory, and Anti-Bacterial Activities for Tendon Repair.ACS Nano. 2023 Sep 12;17(17):16798-16816. doi: 10.1021/acsnano.3c03556.Burton I, McCormack A.Nutritional Supplements in the Clinical Management of Tendinopathy: A Scoping Review.J Sport Rehabil. 2023 May 5;32(5):493-504. doi:10.1123/jsr.2022-0244.Hjerrild JN, Wobbe A, Stausholm MB, Larsen AE, Josefsen CO, Malmgaard-Clausen NM,et al.Effects of long-term physical activity and diet on skin glycation and Achilles tendon structure.Nutrients. 2019 Jun 22;11(6):1409. doi:10.3390/nu11061409
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Loiacono C, Palermi S, Massa B, et al.Tendinopathy: Pathophysiology, therapeutic options, and role of nutraceutics. A narrative literature review.Medicina (Kaunas). 2019;55(8):447. doi:10.3390/medicina55080447American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Singh DP, Barani Lonbani Z, Woodruff MA, Parker TJ, Steck R, Peake JM.Effects of topical icing on inflammation, angiogenesis, revascularization, and myofiber regeneration in skeletal muscle following contusion injury. Front Physiol. 2017;8:236597.Pavlova AV, Shim JSC, Moss R, Maclean C, Brandie D, Mitchell L,et al.Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis.Br J Sports Med. 2023 Oct;57(20):1327-1334. doi:10.1136/bjsports-2022-105754Zhang C, Jia Z, Li J, Wang X, Yang S.Impact of lifestyle and clinical factors on the prognosis of tennis elbow.Sci Rep. 2024 Feb 6;14(1):3063. doi:10.1038/s41598-024-53669-xÇetin BV, Sepetçi Ö, Yazar İ, Kaptan AY, Orhan Ö, Demir M,et al.Comparison of local massage, steroid injection, and extracorporeal shock wave therapy efficacy in the treatment of lateral epicondylitis.Jt Dis Relat Surg. 2024 Apr 26;35(2):386-395. doi:10.52312/jdrs.2024.1648Ragone F, Pérez-Guillén S, Carrasco-Uribarren A, Cabanillas-Barea S, Ceballos-Laita L, Rodríguez-Rubio PR,et al.The Effects of Soft-Tissue Techniques and Exercise in the Treatment of Patellar Tendinopathy-Systematic Review and Meta-Analysis.Healthcare (Basel).2024 Feb 7;12(4):427. doi:10.3390/healthcare12040427Yang J, Zhou X, Ma Q, Woods JT, Mohabbat AB, Do A,et al.Efficacy and safety of Tuina for chronic nonspecific low back pain: A PRISMA-compliant systematic review and meta-analysis.Medicine (Baltimore). 2023 Mar 3;102(9):e33018. doi:10.1097/MD.0000000000033018Guo M, Zhang M, Guo X, Wang H, Li H.Acupuncture combined with Tuina in the treatment of cervical longus tendinitis: A case report.Medicine (Baltimore). 2023 Nov 17;102(46):e35980. doi:10.1097/MD.0000000000035980National Center for Complementary and Integrative Health.Massage therapy: What you need to know.Kubo K, Yasuda A, Yajima H, Takayama M, Takakura N.Effects of acupuncture and acupressure of the acupoint compared to the tendon on the blood circulation of human tendon in vivo.Eur J Appl Physiol. 2024 Jan;124(1):269-279. doi:10.1007/s00421-023-05277-2Stoychev V, Finestone AS, Kalichman L.Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review.Curr Rev Musculoskelet Med. 2020 Feb;13(1):133-140. doi:10.1007/s12178-020-09608-0.Fusini F, Bisicchia S, Bottegoni C, Gigante A, Zanchini F, Busilacchi A.Nutraceutical supplement in the management of tendinopathies: a systematic review.Muscles Ligaments Tendons J. 2016 May 19;6(1):48-57. doi:10.11138/mltj/2016.6.1.048Noriega-González DC, Drobnic F, Caballero-García A, Roche E, Perez-Valdecantos D, Córdova A.Effect of vitamin C on tendinopathy recovery: A scoping review.Nutrients. 2022 Jun 27;14(13):2663. doi:10.3390/nu14132663Zhang Q, Yang Y, Suo D, Zhao S, Cheung JC, Leung PH,et al.A Biomimetic Adhesive and Robust Janus Patch with Anti-Oxidative, Anti-Inflammatory, and Anti-Bacterial Activities for Tendon Repair.ACS Nano. 2023 Sep 12;17(17):16798-16816. doi: 10.1021/acsnano.3c03556.Burton I, McCormack A.Nutritional Supplements in the Clinical Management of Tendinopathy: A Scoping Review.J Sport Rehabil. 2023 May 5;32(5):493-504. doi:10.1123/jsr.2022-0244.Hjerrild JN, Wobbe A, Stausholm MB, Larsen AE, Josefsen CO, Malmgaard-Clausen NM,et al.Effects of long-term physical activity and diet on skin glycation and Achilles tendon structure.Nutrients. 2019 Jun 22;11(6):1409. doi:10.3390/nu11061409
Loiacono C, Palermi S, Massa B, et al.Tendinopathy: Pathophysiology, therapeutic options, and role of nutraceutics. A narrative literature review.Medicina (Kaunas). 2019;55(8):447. doi:10.3390/medicina55080447
American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.
Singh DP, Barani Lonbani Z, Woodruff MA, Parker TJ, Steck R, Peake JM.Effects of topical icing on inflammation, angiogenesis, revascularization, and myofiber regeneration in skeletal muscle following contusion injury. Front Physiol. 2017;8:236597.
Pavlova AV, Shim JSC, Moss R, Maclean C, Brandie D, Mitchell L,et al.Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis.Br J Sports Med. 2023 Oct;57(20):1327-1334. doi:10.1136/bjsports-2022-105754
Zhang C, Jia Z, Li J, Wang X, Yang S.Impact of lifestyle and clinical factors on the prognosis of tennis elbow.Sci Rep. 2024 Feb 6;14(1):3063. doi:10.1038/s41598-024-53669-x
Çetin BV, Sepetçi Ö, Yazar İ, Kaptan AY, Orhan Ö, Demir M,et al.Comparison of local massage, steroid injection, and extracorporeal shock wave therapy efficacy in the treatment of lateral epicondylitis.Jt Dis Relat Surg. 2024 Apr 26;35(2):386-395. doi:10.52312/jdrs.2024.1648
Ragone F, Pérez-Guillén S, Carrasco-Uribarren A, Cabanillas-Barea S, Ceballos-Laita L, Rodríguez-Rubio PR,et al.The Effects of Soft-Tissue Techniques and Exercise in the Treatment of Patellar Tendinopathy-Systematic Review and Meta-Analysis.Healthcare (Basel).2024 Feb 7;12(4):427. doi:10.3390/healthcare12040427
Yang J, Zhou X, Ma Q, Woods JT, Mohabbat AB, Do A,et al.Efficacy and safety of Tuina for chronic nonspecific low back pain: A PRISMA-compliant systematic review and meta-analysis.Medicine (Baltimore). 2023 Mar 3;102(9):e33018. doi:10.1097/MD.0000000000033018
Guo M, Zhang M, Guo X, Wang H, Li H.Acupuncture combined with Tuina in the treatment of cervical longus tendinitis: A case report.Medicine (Baltimore). 2023 Nov 17;102(46):e35980. doi:10.1097/MD.0000000000035980
National Center for Complementary and Integrative Health.Massage therapy: What you need to know.
Kubo K, Yasuda A, Yajima H, Takayama M, Takakura N.Effects of acupuncture and acupressure of the acupoint compared to the tendon on the blood circulation of human tendon in vivo.Eur J Appl Physiol. 2024 Jan;124(1):269-279. doi:10.1007/s00421-023-05277-2
Stoychev V, Finestone AS, Kalichman L.Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review.Curr Rev Musculoskelet Med. 2020 Feb;13(1):133-140. doi:10.1007/s12178-020-09608-0.
Fusini F, Bisicchia S, Bottegoni C, Gigante A, Zanchini F, Busilacchi A.Nutraceutical supplement in the management of tendinopathies: a systematic review.Muscles Ligaments Tendons J. 2016 May 19;6(1):48-57. doi:10.11138/mltj/2016.6.1.048
Noriega-González DC, Drobnic F, Caballero-García A, Roche E, Perez-Valdecantos D, Córdova A.Effect of vitamin C on tendinopathy recovery: A scoping review.Nutrients. 2022 Jun 27;14(13):2663. doi:10.3390/nu14132663
Zhang Q, Yang Y, Suo D, Zhao S, Cheung JC, Leung PH,et al.A Biomimetic Adhesive and Robust Janus Patch with Anti-Oxidative, Anti-Inflammatory, and Anti-Bacterial Activities for Tendon Repair.ACS Nano. 2023 Sep 12;17(17):16798-16816. doi: 10.1021/acsnano.3c03556.
Burton I, McCormack A.Nutritional Supplements in the Clinical Management of Tendinopathy: A Scoping Review.J Sport Rehabil. 2023 May 5;32(5):493-504. doi:10.1123/jsr.2022-0244.
Hjerrild JN, Wobbe A, Stausholm MB, Larsen AE, Josefsen CO, Malmgaard-Clausen NM,et al.Effects of long-term physical activity and diet on skin glycation and Achilles tendon structure.Nutrients. 2019 Jun 22;11(6):1409. doi:10.3390/nu11061409
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