Complete Balance Physiotherapy

Tendon Pain

Tendon Pain

Tendon pain, referred to as tendinopathy, is debilitative condition that commonly affects the Achilles.

Common signs and symptoms of tendinopathy include:

  • A stiff and painful tendon in the morning
  • Pain with running that can ease with warming up
  • Latent pain and stiffness post exercise
  • A thickened/ swollen tendon that is tender to touch

Tendon pain is a response to abnormal over load of the musculo-tendionous unit. This can be from a sudden unaccustomed load or general overuse/ overtraining such as:

  • A long run after a 2-3 weeks off running
  • A short sprint after the bus for some one who seldom runs

There are three stages of tendinopathy pathology that is important to determine correctly in order to manage effectively. The three stages are:

  • Reactive Stage “flare up”
  • Dysrepair Stage
  • Degenerative stage “grumbly old tendon”

Ultrasound scan may be required to actually assess the stage of the condition.


As part of a comprehensive treatment plan, your physiotherapist should:

  • Identify & correct contributing factors such as:
    1. Biomechanics
    2. Muscle strength and control
    3. Range of motion
    4. Training technique and equipment
  • Local treatment may involve
    1. Soft tissue massage
    2. Dry needling
    3. Trigger point release
  • Prescription of a progressive loading program
    1. Strength training: Isometric, eccentric and concentric training

Take Home Message

  • Conservative management is your best option
  • Set reasonable expectations: Tendons take time
  • Early diagnosis and management improves long term outcome
  • Must correct pre disposing & biomechanical factors
  • Load management is the key