Pain and functional limitation are frequent in symptomatic tendinopathy. The essential lesion of tendinopathy is a failed healing response. Understanding the cellular and molecular mechanisms involved in a failed healing response during the early stages of pathogenesis of tendinopathy would help to develop new and effective treatments. The role of inflammation in the development of tendon pathologies has been revived during the last few years, in particular during the first phases of tendinopathies, when "early tendinopathy" may not be clinically evident. This review outlines the possible molecular events that occur in the first phases of tendinopathy onset, stressing the role of pro-inflammatory cytokines, proteolytic enzymes, growth factors and healing genes in the development of tendon disorders.