Your Guide to Tendon Injuries

03 November 2017

Your Guide to Tendon Injuries

Achilles tendon in the heel, Rotator Cuff in the shoulder, Tennis or Golfer’s Elbow, Patella tendon in the knee or Hamstring tendon in the back of the hip.

There are lots of tendons in the body, all different sizes and structures but all with broadly the same role – to transmit the force from your muscles to your bones to allow you to move.

They are incredibly strong and some of the larger ones like the Achilles can comfortably handle many multiples of body weight.

So why do we get pain in a tendon?

The most important thing when understanding tendon injury is knowing the type of work and the frequency of that work the tendon was doing prior to the injury. I don’t like the terms ‘overuse’ or ‘repetitive strain’ as many people do very repetitive tasks for long periods of time with no tendon symptoms and tendons are designed to transmit force time and time again. The issue really is how prepared the tendon is for the task.

A person who has not been regularly active deciding they wish to take up running and in the enthusiasm of starting a new activity, just does a little more than the tendon was prepared for and so starts to get some pain.
In the same way a professional athlete who regularly trains everyday gets a new coach who wants to increase their training. The tendon just is not quite prepared for this increase and so in spite of being very fit and strong begins to get some tendon pain.


Hopefully this illustrates that it is not so important whether you have not done lots of activity or you are super fit. It is more about allowing your body to adapt to changes in activity.

How do we put it right?

In short, we need to train it to cope with the demand that will be placed on it.

Rest does not work for tendon problems as it allows the tendon to further reduce its ability to transmit force. If we don’t use its strength we will begin to lose it.

Injections of any sort have a mixed response and in high load bearing tendons have been shown to be unhelpful.

External supports can make it feel better but don’t make it stronger or better able to cope with load.

We need to use exercise.

Static resistance is good way to work a tendon if it is very painful and then it needs to be progressed into movement, speed, power etc at the right pace to allow its load bearing capability to grow, until it can cope with everything you will need it to do.

This sounds simple but it can be quite tricky to get right, some tendon problems respond better to different types of movement or exercises and so I would recommend getting an assessment with a physiotherapist to help you to understand your symptoms and get a plan in place to get you better.


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