Pain in the tendon


September 16, 2018

Belinda is an APA Sports Physio has a strong interest in treating the difficult tendon. This is due to both her clinical involvement with the problem and her invested interest researching the area after being an invited speaker to both The International Tennis Medicine conference in 2016 and also last year at Tennis Australia’s Annual Sports Medicine Workshop. Here is a snap-shot of what she see’s as the key aspects of Tendon management

Tendon injuries are classically frustrating requiring patience and commitment to rehabilitation with no quick fix.


Tendinopathy otherwise previously known as tendinitis is pathology and pain in a tendon.

Common sites of tendon injuries include:

– Tennis elbow (outside of elbow)

– Golfer’s elbow (inside of elbow)

– Achilles

– Patella

– Hamstring

-Gluteal (hip)


Tendon pain is always associated with a change in load, usually a new or excessive load. For example, a spike in training and an unaccustomed session such as a hill sprint session may cause Achilles tendinopathy, whereas painting a house all weekend for an office worker may flair up tennis elbow


– Manage load: avoid aggravating loads such as plyometrics and high loads to tendon

– Get strong: the single most important way to rehab is customized strength and rehab

– Cross train: to maintain fitness if running aggravates tendon keep fitness with cycling

– Avoid touching/ rubbing sore tendon

– There is no recipe, treatment is individualized

– Avoid stretching, this may cause more compression in the tendon. Instead tight muscles can be loosened with massage, or self massage with a foam roller or tennis ball

– Avoid doing nothing- resting completely can be detrimental to tendon, weakening the tendon and the muscle from inactivity

Strengthening Technique

Tendon Strengthening Techniques


– Strength training is the most important component of tendon rehabilitation with emerging research demonstrating benefits of both isometric and heavy slow resistance training. Strengthening of the kinetic chain and around the injured tendon is required to have a good strength base and muscle balance.

– There is no recipe and exercise programs need to be individualized

– The first phase of strengthening:  Isometric

  • Isometrics are able to strengthen the tendon and may have pain relief and benefit due to the static nature of the exercise
  • Exercises may be performed in mid range with 4 sets of up to 45 second holds may be completed up to 4 times daily

– The second phase of strengthening: Heavy slow loading

  • Heavy slow loading will improve the strength of the muscle and tendon and is a must do phase in tendon rehabilitation

– The third phase: Plyometric

  • Speed and high intensity training can slowly be introduced once tendon pain is controlled and there is a good base of strength. This may take up to 3-6 months to introduce

You must buy into your tendon rehabilitation and commit to a program, unfortunately rehabilitation can be slow (typically at least 12 weeks).

For a consultation with one of our Physiotherapists call Grand Slam Physiotherapy, (03) 5277 2151