Tendon pain can be frustrating. It may begin as a mild ache after exercise, become uncomfortable during everyday activities and eventually start affecting work, sleep or the activities you enjoy.
The good news is that tendon pain can often be managed successfully with the right combination of education, activity modification and progressive rehabilitation. Understanding why tendinopathy develops is an important first step towards recovery.
What is tendinopathy?
Tendons are strong bands of connective tissue that attach muscles to bones and help transfer force when we move. They are designed to tolerate considerable loads, but problems can develop when the demands placed on a tendon exceed its capacity to adapt and recover.
Tendinopathy is not simply an inflammation of the tendon. Research has shown that tendon problems involve complex changes in tendon structure, cells and how the tissue responds to mechanical loading. The relationship between tendon structure and pain is also complicated: structural changes can sometimes be present without symptoms. Recent research on tendon loading and tendinopathy explains why managing and progressively adapting tendon load is an important part of rehabilitation.
Why does tendon pain develop?
There is rarely one single cause. Tendinopathy can develop when a tendon is repeatedly exposed to more load than it can currently tolerate.
This might happen after:
- A sudden increase in exercise or training
- Returning to sport after a period of inactivity
- Repetitive movements at work
- Changes to running, walking or sporting activities
- Reduced muscle strength or conditioning
- Insufficient recovery between activities
Age can also influence tendon health, but tendon pain isn’t an inevitable part of getting older. The aim is to find an appropriate level of activity and gradually build the body’s capacity to tolerate it.
Common tendon problems
Tendinopathy can affect many areas of the body. Two particularly common examples are Achilles tendon pain and tennis elbow.
Achilles tendon pain
Achilles tendinopathy can cause pain and stiffness around the back of the ankle, particularly during running, jumping or walking uphill. It can affect both athletes and people who are simply increasing their everyday activity.
Exercise-based rehabilitation is an important part of treatment. A systematic review and meta-analysis published in the British Journal of Sports Medicine found evidence to support exercise for improving pain and function in Achilles tendinopathy, while also finding that no single exercise approach was indicated in all circumstances.
More recent evidence continues to support progressive exercise rehabilitation, while highlighting the importance of tailoring the programme to the individual. A 2026 systematic review of conservative management identified exercise-based rehabilitation as having the strongest evidence among conservative approaches.
Tennis elbow
Despite its name, tennis elbow (lateral elbow tendinopathy) doesn’t only affect tennis players. It can cause pain around the outside of the elbow and may make gripping, lifting or repetitive arm movements uncomfortable.
Evidence suggests that exercise can be useful in managing lateral elbow tendinopathy. A systematic review and meta-analysis of 30 randomised controlled trials found that exercise interventions produced better outcomes than passive interventions.
How can physiotherapy help?
If you’re searching for tendon pain treatment, physiotherapy can provide a structured approach to understanding what’s contributing to your symptoms whilst helping you gradually return to normal activity.
During a physiotherapy appointment for tendinopathy, your practitioner may assess:
- Your symptoms and activity levels
- Strength and mobility
- How you move and load the affected area
- Recent changes in exercise or workload
- Factors that may be contributing to persistent symptoms
Treatment can then be tailored to your individual needs. This may include education, temporary modification of aggravating activities, hands-on treatment where appropriate, and a progressive strengthening programme.
When considering physiotherapy for tennis elbow, for example, research supports exercise as part of rehabilitation, while studies also suggest that combining approaches may be appropriate depending on the individual presentation.
Don’t stop moving — adapt your activity
One of the most important principles of tendon rehabilitation is that complete rest isn’t always the answer. Tendons need appropriate mechanical loading to maintain their capacity.
The goal is usually to find a level of activity that your tendon can tolerate and then gradually increase the load as symptoms and function improve. This approach allows you to work towards the activities that matter to you rather than simply avoiding them.
When should you seek help?
Consider professional assessment if tendon pain:
- Persists or keeps returning
- Is affecting exercise or everyday activities
- Is becoming progressively worse
- Is limiting your strength or movement
- Hasn’t improved despite modifying your activity
At Osteo & Physio, our experienced clinicians take a personalised, evidence-informed approach to musculoskeletal care. We can assess your symptoms, identify contributing factors and develop a rehabilitation programme around your lifestyle and goals.
Find out more about physiotherapy at Osteo & Physio or explore our sports injury treatment.
If tendon pain is stopping you doing the things you enjoy, book an appointment and take the first step towards moving with greater confidence.
Meet Melissa Doble-Headon: Physiotherapy for Tendon Pain and Injury Recovery
If you’re dealing with persistent tendon pain, having the right guidance can make a real difference. Melissa Doble-Headon, one of our physiotherapists at Osteo & Physio, has a particular interest in sports injuries, rehabilitation and long-term injury prevention.
Melissa holds a BSc (Hons) in Physiotherapy from the University of Gloucestershire and has completed a range of musculoskeletal placements, including experience with Somerset County Cricket Club. Her background in competitive gymnastics and university-level cheerleading has also given her first-hand insight into physical performance, injury recovery and the demands placed on the body.
Her approach combines hands-on techniques, personalised advice and progressive exercise programmes, with rehabilitation plans tailored around each person’s goals and lifestyle. Whether you’re recovering from a sporting injury or experiencing tendon pain that is affecting everyday activities, Melissa can help you understand what’s contributing to your symptoms and develop a structured plan to build strength and confidence.
Melissa also provides physiotherapy support to Okehampton Ladies RFC and remains active herself through running, cycling, gymnastics coaching and gym training.
Want help with a persistent tendon problem?Â
Find out more about Melissa Doble-Headon or book a physiotherapy appointment with Osteo & Physio.