Tendons are rope like structures that connect muscle to bone allowing movement every time we contract a muscle.

Tendons are good at absorbing tension but not at dealing with compression.

Changes in exercise/activities and poor daily postural habits can increase this compression. With enough compression, changes occur at a cellular level within the tendon and is referred to as tendinopathy. This involves swelling of the tendon which can be quite painful. If the tendon is left untreated it will progress to a degenerative phase. The good news is that the tendon has the capacity to reverse and change, particularly in the initial phases.

It is very important to unload the compression on the tendon.

Everyone can get a tendinopathy from elite athletes to sedentary workers. Tendons do not like dramatic change and do not respond to rest alone, so it is important to follow the guidelines and an appropriate graduated strengthening programme.

The cellular changes that occur during tendinopathy from compression can also develop from tears or general overuse. Other changes that occur in the tendon are neovascularisation which is an in- crease in blood and nervous tissue supply and calcification which is calcium build up that hardens.

Often individuals who present with a tear in the tendon, may have previously developed a tendinopathy that they where not aware of. By the same token an acute tendon tear that does not heal properly can develop into a tendinopathy.

Tendinopathy’s are occasionally and in- correctly referred to as a tendinitis.

Activity guide

The resilience of a tendon can be strengthened. The tendon will adapt itself slowly as long as the stress is not greater than the tendon’s capacity to adapt.

You know you have done too much if:

  • You exercise with pain more then 3/10 which escalates (10=worst)
  • You have increased pain for more then 2 hours of activity
  • You have increased night pain
  • You have increased pain in the morning

Ways your physiotherapist may help you:

  • Decreasing tightness in the local muscles and maintaining range of movement to reduce compression of tendon
  • Graduated strengthening program to increase the tendons ability to load
  • Specific exercise advice tailored to your particular problem.
  • Functional strengthening to specifically target problematic activities.
  • Decompression taping and advice on how to deload a tendon.

Interesting Facts

Some factors that increase your risk of developing a tendinopathy:

  • Excess abdominal fat and diabetes
  • Hormonal changes—increase risk for peri/post menopausal women
  • Poor diet