What is a Tendinopathy?

What is it?

Tendons connect muscle to bone and transfer the forces that move you. Tendinopathy is the term used when a tendon becomes painful and a little less efficient at handling load – commonly the Achilles, patellar (knee), rotator cuff, hamstring, glute or elbow tendons.

It is almost always a load problem: the tendon has been asked to do more than it is currently used to. The good news is that tendons respond very well to the right kind of loading – they get stronger and less painful with rehab.

There is a breakdown continuum. So some people might just inflame the sheath acutely, others may have chronic changes so rehab can look extremely different.

What helps the most

•    Don’t fully rest. Tendons need load to recover. Reduce the most aggravating activities for a short time, but keep the muscle working.

•    Progressive strengthening. Heavy, slow strength work (or eccentric/isometric loading) is the most evidence-based treatment.

•    Be patient. Tendons typically take 8–12 weeks (sometimes longer) to settle properly. A small amount of pain during exercise is acceptable, as long as it settles within 24 hours. It takes time because we are actively trying to change the tendon structure. So loading it, let it repair, and repeat.

•    Track the load. Spikes in volume – hills, jumps, new shoes, new gym program – are common triggers and need to be avoided/mitigated. Build up gradually.

•    Passive treatments alone (massage, ice, ultrasound) feel nice but rarely change the tendon. They’re an add-on, not the plan.

When to seek further advice

·       A sudden “pop”, swelling, or inability to push off / contract the muscle – may indicate a tear

·       Pain that worsens steadily despite consistent rehab over 8–12 weeks

·       Marked night pain, fever, or red, hot swelling

How we can help

·       At Elite Performance Physio we focus on finding the true source of your problem, not just chasing symptoms. Your plan combines hands-on treatment, education and a tailored exercise program built around your goals – so you get back to doing what you love, stronger than before.

·       We can do capacity and strength testing to see exactly how far away your strength is, giving you a more accurate indicator of recovery time.

·       We can use dry needling and cupping for effective pain management.

·       We can provide weekly programming (similar to a PT) so we can monitor the load, without the need to face to face.

·       If you are under a PT or do classes we can work with your coach to edit your program and keep them informed.

·       So whether your exercise choice is strength, running or even pilates, we make rehab fit in with what you have access too.