Tendinopathy is one of the common problems we see in our clinic. It is often responsible for persistent pain around joints such as the shoulder, elbow, knee, Achilles tendon and foot.
Many people assume the problem is inflammation, but tendinopathy is usually more complex than that. Understanding what is happening in the tendon can help explain why the right treatment approach is so important.
What Is a Tendon?
Tendons are strong bands of connective tissue that attach muscles to bones. When your muscles contract, tendons transmit that force to move your joints.
Because they are involved in almost every movement we make, tendons are placed under regular load. When that load becomes too great, or increases too quickly, the tendon can become irritated and painful.
What Is Tendinopathy?
Tendinopathy is a term used to describe pain and dysfunction in a tendon. In many cases the tendon structure changes over time due to repeated strain or overload. Rather than being a simple inflammatory injury, the tendon may develop small structural changes that affect how it handles load.
This is why symptoms often develop gradually rather than after a single injury.
Common Areas Affected
Tendinopathy can occur in several parts of the body, but the most common areas include:
• shoulder tendons (rotator cuff)
• elbow tendons (tennis elbow or golfer’s elbow)
• patellar tendon at the knee
• Achilles tendon at the back of the ankle
• plantar fascia under the foot
These areas are regularly exposed to repetitive movement and load.
Symptoms of Tendinopathy
People with tendinopathy often experience:
• pain when using the affected area
• stiffness, particularly in the morning
• tenderness when touching the tendon
• discomfort when exercising or loading the joint
• pain that improves with movement but returns later
Symptoms may come and go at first, but without the right management they can persist for months.
Why Rest Alone Often Does Not Solve the Problem
A common mistake is to completely rest the tendon for long periods.
While short term rest can help calm symptoms, tendons actually need gradual and appropriate loading to recover properly. Avoiding movement completely can make the tendon weaker and more sensitive over time.
This is why rehabilitation exercises are usually an important part of treatment.
How Physiotherapy Can Help
Physiotherapy aims to identify the underlying cause of the tendon problem and gradually restore its ability to tolerate load.
Treatment may include:
• specific strengthening exercises
• gradual return to activity or sport
• advice on managing training loads
• manual therapy
• treatments such as shockwave therapy
The goal is not simply to reduce pain, but to improve the tendon’s ability to cope with everyday demands.
When Should You Seek Help?
If pain around a tendon has been present for several weeks, or continues to return when you try to exercise, it may be worth having it assessed.
Early treatment can often prevent the problem becoming more persistent.
