Tendon troubles?

Whether you’re an athlete, a weekend warrior, or simply someone who enjoys staying active, tendon pain can be a frustrating and limiting experience. Understanding what tendons are, how they function, and how to manage tendon-related conditions like tendinopathy is key to maintaining your mobility and getting back to doing what you love.

What is a tendon?

A tendon is a strong, fibrous band of connective tissue that connects muscle to bone. Tendons play a crucial role in movement by transmitting the force generated by muscles to the bones, allowing you to move your joints. These structures are incredibly resilient and are designed to withstand significant tensile (pulling) forces during activities like walking, running, jumping, and lifting.

However, tendons are not indestructible. When subjected to excessive loading, repetitive strain, or improper biomechanics over time, tendons can begin to break down. This can lead to painful conditions broadly referred to as tendinopathies.

Tendinopathy vs Tendinosis

While the terms are often used interchangeably, there are important distinctions between tendinopathy and tendinosis.

• Tendinopathy is a general, umbrella term used to describe any tendon-related condition that causes pain, swelling, or impaired function. It can affect any tendon in the body, but is most common in areas like the Achilles tendon, patellar tendon (knee), and rotator cuff (shoulder).

• Tendinosis, on the other hand, refers specifically to the chronic degeneration of tendon tissue. This involves the breakdown of collagen fibres—the building blocks of tendons—without the presence of inflammation. A health professional may identify tendinosis based on your symptoms or through imaging such as ultrasound or MRI.

Understanding the type and severity of your tendon issue is crucial in choosing the right treatment path.

When does the pain occur?

Tendon pain doesn’t always show up during activity. In fact, many people report increased pain during periods of rest or inactivity, especially after the tendon has been loaded the day before.

For example, individuals with Achilles tendinopathy often notice stiffness and pain when first getting out of bed in the morning or after sitting for extended periods. Interestingly, many people find that the pain begins to subside once they start moving and “warm up.” However, if the tendon continues to be irritated, the pain may return after activity or worsen over time.

How to manage a tendon problem

The good news? Tendons can recover, and the right type of exercise is one of the most effective tools in rehabilitation.

The role of loading

One of the biggest misconceptions is that rest alone will fix a tendon issue. While short-term rest can help reduce pain, tendons actually need gradual, progressive loading to heal and become more resilient. This means introducing the right types of exercises at the right time.

Research shows that heavy, slow resistance training is particularly effective. This includes both eccentric movements (where the muscle lengthens under tension, such as lowering a weight) and isometric and concentric exercises (where the muscle either stays the same length or shortens under tension). A well-rounded rehab program should include all of these.

Other key tips:

• Consistency is key: Tendon rehab often takes weeks to months, so sticking with your program is important.

• Avoid complete rest for too long: While rest may reduce symptoms short-term, tendons become weaker without load.

• Work with a health professional: A Physiotherapist or Exercise Physiologist can create a tailored program based on your specific condition and progress it safely.