Have you ever felt a dull ache near your elbow, knee, or heel that just won’t go away? You’re not alone. Tendinopathy is one of the most common causes of persistent pain in active people—and even in those who sit all day. But what exactly is it, and why does it happen? At Good Physio, we believe understanding your condition is the first step toward real recovery.
What is Tendinopathy?
Tendinopathy is an umbrella term that describes a problem with a tendon—typically involving pain, thickening, and reduced function. It used to be called “tendinitis,” which implies inflammation, but we now know it’s often more complex than simple inflammation.
It can affect many parts of the body, but the most common areas include:
- Achilles tendon (back of the ankle)
- Patellar tendon (Jumper’s knee: front of the knee)
- Lateral elbow tendon (tennis elbow: outer side of elbow)
- Rotator cuff tendons (shoulder)
Why Do Tendons Get Sore?
Tendons are tough, fibrous tissues that connect muscles to bones and help us move. They love consistent loading—like walking, lifting, or running at a manageable intensity. But problems arise when there’s either:
- Too much load too quickly (e.g., a sudden spike in training or repetitive work)
- Too little load over time (e.g., long periods of inactivity or poor movement patterns)
These changes can lead to small-scale degeneration in the tendon, causing:
- Pain during or after activity
- Morning stiffness or tightness
- Tenderness to touch
- Loss of strength or performance
Is It Inflammation?
Not exactly. While inflammation can play a role, most tendinopathies are not driven by inflammation alone. Instead, the tendon structure becomes disorganised due to overload. That’s why anti-inflammatory treatments like ice or medication don’t always work long-term.
What we Can Do for your tendinopathy
Here’s what we recommend at Good Physio:
✅ 1. Accurate Diagnosis
Not all tendon pain is the same. We begin by identifying which tendon is involved, and whether you’re in the reactive (early), dysrepair (subchronic), or degenerative (chronic) stage.
✅ 2. Progressive Loading Program
One of the most effective treatments for tendinopathy is a structured, progressive loading program—carefully designed exercises that rebuild tendon capacity. Especially, Heavy Slow Resistance (HSR) training is proven to improve the tendon capacity, exercise tolerance, muscular strength, and patient’s satisfaction. We will share about HSR training later in the future blog.
✅ 3. Modify, Don’t Stop
Complete rest usually doesn’t help. Instead, we guide you on how to stay active without making things worse. Load management is key.
✅ 4. Manual Therapy When Needed
Some cases benefit from hands-on treatment, particularly if surrounding muscles and joints are compensating or stiff.
✅ 5. Supportive Therapies
In early or painful stages, treatments like night wraps or topical agents (we’ll share more on this in the next blog!) can help reduce symptoms and support healing.
✅ 6. Referral if needed.
Some cases benefit from referral for multidisciplinary management for the best outcome. The current evidence does not support corticosteroid injection for treating tendinopathy in clinical practice as the cortisone injection only shows short-term pain relief effect, while it increases risk of tendon rupture (Visser et al., 2024). Specialist referral for corticosteroid injection is discouraged. However, physios from Good Physio can arrange ultrasound imaging and podiatrist referral (for Achilles tendinopathy) if required.
When to Seek Help
If your tendon pain:
- Has lasted more than 2–3 weeks,
- Is affecting your daily or sporting life,
- Or keeps coming back—
…it’s time to get it properly assessed. The sooner we catch it, the better the outcome.
Final Thoughts
Tendinopathy doesn’t have to be a long-term struggle. With the right diagnosis, guidance, and exercise plan, your tendon can heal and even come back stronger. At Good Physio, we’re here to help you move better, feel stronger, and stay active—pain-free.
👉 Click here for the blog about Night Wraps, a simple at-home method to ease inflammation in irritated tendons.
References
1. Sleeswijk Visser, T., van Linschoten, R., Vicenzino, B., Weir, A., & de Vos, R.-J. (2024). Terminating Corticosteroid Injection in Tendinopathy? Hasta la Vista, Baby. Journal of Orthopaedic and Sports Physical Therapy, 54(1), 10-13. Article 54. https://doi.org/10.2519/jospt.2023.11875