The TriDoc Podcast, triathlon and health in one place · Dr. Jeff Sankoff

Tendonitis: Is it really what we think it is? Plus Hillary Topper's Journey to Open Water

·1 hr 6 min·4 clips

Tendonitis is “exceedingly uncommon”; most tendon pain is tendinosis, not inflammation.

1. The TriDoc Podcast episode focuses on Ironman qualification changes and the medical mailbag on tendon pain. 2. Host Jeff Sankoff is an emergency physician, triathlete, triathlon coach, and multiple Ironman finisher broadcasting from Denver, Colorado. 3. The episode asks whether Ironman’s new slot allocation and the usual idea of “tendonitis” are both being misunderstood. 4. Jeff says the new Ironman World Championship and 70.3 World Championship qualification process looks like an improvement for faster women and older age groups. 5. He also says the Muskoka 70.3 results suggest the performance pool still skews heavily toward men. 6. Jeff raises a specific question about how Ironman will fill a full women’s 70.3 World Championship field. 7. He asks whether women-for-tri slots are still part of the system. 8. Juliet Hockman joins the medical mailbag and asks about tendonitis, tendon pain, and prevention. 9. Justin Raphael, described as one of Jeff’s athletes and an active Facebook-group contributor, prompted the tendon question. 10. Jeff says tendonitis is an acute inflammatory process but is exceedingly uncommon in the tendon problems triathletes usually get. 11. He contrasts tendonitis with tendinosis and tendinopathy, saying the latter involve degeneration and tissue breakdown. 12. He explains that Achilles and patellar tendon problems are the tendon sites where inflammation is most likely. 13. He says gluteal, hamstring, shoulder, rotator cuff, and elbow tendon problems are usually degenerative rather than inflammatory. 14. Jeff describes normal tendon tissue as glossy white, and diseased tendon as boggy, brownish, and structurally damaged. 15. He says tendinosis shows collagen gaps, fewer normal collagen-forming cells, and abnormal blood vessel growth under the microscope. 16. Jeff and Juliet compare treatment paths by saying chronic tendon problems can take three to six months or longer to settle. 17. Jeff says supplements, potions, NSAIDs, and corticosteroids are not the answer for tendinopathy. 18. He says heavy lifting, offloading devices, and correcting the original movement problem are central to recovery. 19. The episode’s tone is conversational and evidence-focused, with Jeff and Juliet using personal injury examples and practical coaching language. 20. Listeners interested in triathlon training, open-water swimming, and sports injury management will get the most from it.

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