Tendinopathy & Tendinitis

Treatment for Tendinitis & Tendon Pain at Revive Physio

Tendon pain can be frustrating. It may start as a small niggle during exercise or everyday activity, but over time it can begin to affect walking, running, climbing stairs, lifting, sleeping or simply doing the things you enjoy.

You may have been told you have tendinitis, tendonitis or tendinopathy. These terms are often used interchangeably, although persistent tendon pain is now more commonly referred to as tendinopathy.

At Revive Physio, a specialist women’s physiotherapy and wellbeing clinic, we assess and treat a wide range of tendon problems. Treatment focuses not only on reducing your pain, but on understanding why the tendon has become painful and gradually rebuilding its ability to cope with load.

We can also incorporate Shockwave Therapy into your rehabilitation where clinically appropriate.

What is Tendinopathy?

Tendons are strong bands of connective tissue that attach muscles to bones and help transfer force when we move.

Tendinopathy occurs when a tendon becomes painful and its ability to tolerate load is reduced.

Although the term tendinitis is still commonly used, particularly by patients searching for help with tendon pain, long-standing tendon problems are not always simply caused by inflammation.

Tendon pain can develop following:

  • A sudden increase in exercise or activity

  • Repetitive movements

  • Running or jumping sports

  • Changes in training intensity or frequency

  • Muscle weakness

  • Reduced tendon capacity

  • Changes in biomechanics

  • Returning to activity after a period of rest

  • A direct injury or trauma

  • Changes in tendon health associated with ageing and midlife

Sometimes there isn't one obvious cause.

What Does Tendinopathy Feel Like?

Tendon pain doesn't always behave like other injuries.

You might notice:

  • Pain when you first start moving

  • Pain or stiffness first thing in the morning

  • Pain after sitting or resting

  • Pain when walking or running

  • Pain climbing stairs

  • Pain when lifting, gripping or reaching

  • Pain during or after exercise

  • Local tenderness around the tendon

  • Stiffness

  • Reduced strength

  • Symptoms that settle when you rest but return as soon as you become active again

A particularly common pattern is pain that feels worse when you first get moving, improves once you have warmed up, and then becomes sore again afterwards.

Common Tendon Problems We Treat

Achilles Tendinopathy

Pain and stiffness around the Achilles tendon at the back of the ankle.

You may notice your first few steps in the morning are particularly painful, discomfort when walking or running, or pain when pushing up onto your toes.

Gluteal Tendinopathy / Lateral Hip Pain

Pain around the outside of the hip, which can sometimes be diagnosed as greater trochanteric pain syndrome or trochanteric bursitis.

Typical symptoms include pain lying on your side, climbing stairs, walking for longer distances or standing on one leg.

It can be particularly common in women during midlife and around the menopause transition.

Tennis Elbow

Despite the name, you don't need to play tennis!

Tennis elbow causes pain around the outside of the elbow and can make gripping, lifting, carrying shopping, using a mouse or even lifting a kettle uncomfortable.

Golfer's Elbow

Pain affecting the inside of the elbow, often aggravated by gripping, lifting or repetitive wrist and forearm movements.

Patellar Tendinopathy

Pain affecting the tendon around the front of the knee, often associated with running, jumping and sports involving repeated changes of direction.

Proximal Hamstring Tendinopathy

Deep pain around the lower buttock where the hamstring attaches to the pelvis.

It may be particularly uncomfortable when sitting, running, accelerating or bending forwards.

Rotator Cuff Tendinopathy

A common cause of shoulder pain.

Symptoms can include pain lifting your arm, reaching overhead, reaching behind your back or lying on the affected shoulder at night.

Other Tendon Problems

We can also assess and treat tendon pain affecting the foot, ankle, wrist and other areas of the body.

Why Doesn't Rest Always Fix Tendon Pain?

This is one of the most important things to understand about tendinopathy.

Rest may temporarily reduce your symptoms because you are placing less load through the painful tendon.

However, complete rest does not necessarily improve the tendon’s ability to tolerate the activities you want it to perform.

This is why you may feel better after taking a break, only for the pain to return when you start walking, running, exercising or lifting again.

Successful tendon rehabilitation therefore usually involves finding the right balance between reducing aggravating loads and progressively strengthening the tendon again.

How Can Physiotherapy Help Tendinopathy?

Your treatment starts with a detailed physiotherapy assessment.

We will look at your symptoms, how they started, what aggravates them and what activities you would like to return to.

Your assessment may include:

  • Movement and joint assessment

  • Tendon loading tests

  • Strength testing

  • Muscle flexibility

  • Functional movements

  • Biomechanics

  • Training or activity levels

  • Factors that may be contributing to continued overload

From there, we develop an individual treatment and rehabilitation programme.

Treatment may include:

Load Management

This doesn't necessarily mean stopping everything.

We help you understand which activities may temporarily need reducing or adapting while keeping you as active as possible.

Progressive Strengthening

Exercise and progressive tendon loading are central to successful tendinopathy rehabilitation.

Your programme will be matched to your current ability and gradually progressed as your tendon becomes stronger and better able to tolerate load.

Manual Therapy

Where appropriate, hands-on physiotherapy can be used alongside your rehabilitation to address associated joint stiffness, muscle tension or movement restrictions.

Shockwave Therapy

For some persistent tendon problems, Shockwave Therapy may be incorporated alongside your physiotherapy and rehabilitation programme.

Shockwave delivers controlled acoustic pressure waves to the affected tissues and is used clinically for a number of persistent musculoskeletal and tendon conditions.

At Revive Physio, shockwave is not used as a stand-alone quick fix. Where appropriate, it forms part of a wider treatment programme incorporating education, load management and progressive rehabilitation.

Tendon Pain & Menopause

Tendon pain can become more noticeable during perimenopause and menopause.

Oestrogen has a role in musculoskeletal and connective tissue health, and hormonal changes during midlife may influence collagen metabolism, tendon structure and the way our tissues respond to load.

If you've suddenly started experiencing problems such as Achilles pain, heel pain, outer hip pain or shoulder pain during midlife, you don't simply have to accept it as part of getting older.

At Revive Physio, we take a whole-person approach and consider the factors that may be contributing to your symptoms rather than simply treating the painful area.

How Long Does Tendinopathy Take to Improve?

Tendons can be slow to adapt, particularly when symptoms have been present for several months.

There isn't one recovery timeframe that applies to everybody.

How quickly you improve can depend on:

  • How long you have had the problem

  • Which tendon is affected

  • Your current strength

  • Your activity levels

  • How irritable the tendon is

  • Other health and lifestyle factors

  • How consistently rehabilitation is followed

The aim is to gradually build the tendon back up so that it can tolerate the activities you need it to do.

When Should I Get My Tendon Pain Assessed?

Consider arranging a physiotherapy assessment if:

  • Your pain keeps returning

  • You've rested but the pain comes back when you exercise

  • Your symptoms have lasted several weeks

  • You're struggling to walk, run or exercise normally

  • Pain is affecting everyday activities

  • You are experiencing persistent morning pain or stiffness

  • You're unsure whether the problem is actually coming from your tendon

  • You've tried exercises yourself but don't know whether you're doing the right ones

  • You want help returning safely to sport or exercise

Not every pain around a tendon is necessarily tendinopathy, which is why getting the right diagnosis first is important.

Tendon Pain Treatment at Revive Physio

If tendon pain is stopping you from walking, running, exercising, sleeping comfortably or doing the things you enjoy, we can help you understand what's causing it and put a clear treatment plan in place.

At Revive Physio – a specialist women’s physiotherapy and wellbeing clinic, treatment is tailored to you and may include physiotherapy, progressive rehabilitation and Shockwave Therapy where clinically appropriate.

Book a Physiotherapy Assessment

Let’s find out what's causing your pain and get you moving comfortably again.