Tendon pain

What is tendon pain?

Tendon pain, known as tendinopathy, is a condition that affects the tendons—the strong bands of tissue that connect muscles to bones. It occurs when a tendon becomes painful, irritated, or damaged, often due to overuse, repetitive strain, or age-related changes.

It can affect any tendon in the body, but common sites include:

• Achilles tendon (heel)
• Rotator cuff (shoulder)
• Patellar tendon (knee)
• Tennis elbow (outside of the elbow)
• Gluteal tendons (hip)

Symptoms

• Pain in or around the affected tendon
• Stiffness, especially in the morning or after rest
• Swelling or thickening of the tendon
• Pain that worsens with activity or load
• Reduced strength or function

Diagnosis

Tendinopathy is usually diagnosed based on:

• Your symptoms and activity history
• Physical examination by a clinician
• Imaging (e.g. ultrasound or MRI) is rarely needed unless symptoms are severe or not improving

Causes and risk factors

• Repetitive movements or overuse
• Sudden increase in activity or training
• Poor biomechanics or posture
• Age-related tendon degeneration
• Medical conditions (e.g. diabetes, obesity, menopause)
• Inadequate recovery or rest

Self-care and management

1. Load management

• Avoid complete rest—this can weaken the tendon further
• Modify activities to reduce strain on the tendon
• Gradually reintroduce load through structured exercise

2. Pain relief

• Use ice packs for 10 to 15 minutes after activity
• Take paracetamol or anti-inflammatory medication if advised by your GP
• Consider orthotics or supportive footwear if needed

3. Exercise Therapy

Exercise is the most effective treatment. Your clinician may recommend:

• Isometric exercises (static holds)
• Eccentric loading (slow, controlled lengthening)
• Progressive strengthening tailored to your goals
• Stretching if appropriate

(Exercises should be done consistently over weeks or months.)

Recovery

• Tendons heal slowly—expect improvement over 16 weeks or more
• Flare-ups are common but usually temporary
• Patience and consistency are key

When to seek medical advice

• Your pain is severe or worsening. Consider seeing your GP.
• Symptoms persist despite self-care and exercise. Consider seeing your GP or referring yourself to the local MSK Service.