No one knows exactly what is going on at the tendon level in any one patient suffering from tendonitis/tendonosis.
There just is not a good test that will tell us how much inflammation really is present.
The bottom line is that it takes a long, long time for tendon to heal.
It has a lousy blood supply, and has to support very high forces.
Most people are familiar with the way a skin injury heals so very quickly in a couple of weeks.
They can't wrap their heads around the concept that different tissues heal at different rates.
Skin is growing at a very rapid rate and has a great blood supply. The pulling force on skin at any one point is quite small.
Tendon isn't growing at all under normal conditions, and has a lousy blood supply. The force of muscle pulling on tendon is great.
People think 2 weeks is a long time - long enough to injured tendon to heal.
They are wrong.