Tendinopathy: what is it and how do you relieve tendinopathy pain?

May 8, 2020 | Education

All our muscles and bones are connected by tendons. Their usual function involves stretching and snapping back into place to help us move. If they can’t do this due to injury, swelling, or inflammation you may be experiencing tendinopathy.

Tendinopathy, also known as tendonitis, can be a painful experience but it can be treated over the course of several weeks with some simple loading exercises.

In this post, I’ll give you an overview of the types of tendinopathy and some exercises which may help.

If you’re in too much pain or want specialist advice, please book an appointment with the clinic so we can develop a personal treatment plan to get moving and living pain-free. Book an appointment.


What is tendinopathy?

Tendons are the elastic bands of your body; they like to stretch and snap back to their original length. Tendinopathy is when the tendons are unable to do this due to overuse or injury.

Tendons respond to healthy doses of loading and it is necessary to stimulate the healing process. But too much load will lead to degeneration instead of regeneration. That’s why we develop a treatment plan with you.

The term tendinopathy is the term used to describe any tendon injury or pain. However, you may also have heard the term ‘tendonitis’ which tends to refer to acute inflammation of the tendons.

While tendinopathy can occur at any age, it tends to affect adults. This is because our tendons lose elasticity and weaken with age. If you play a lot of sport or work in a job which requires repetitive movements, you may be more at risk.

A diagram showing a healthy tendon and a tendon damaged by or experiencing tendinopathy.

An example of tendinopathy and how it affects the tendons. From Pathogenesis and Management of Tendinopathies in Sports Medicine by Mead et al,. (2017)


How many types are there?

There aren’t specific types of tendinopathy, but the area affected often gives the injury its name. Here are some examples from the NHS:

  • Patellar tendonitis/jumper’s knee

  • Tennis elbow/golfer’s elbow

  • Calcific tendonitis or supraspinatus tendonitis (affecting shoulders)

  • De Quervain’s disease (affecting wrists and thumbs)

  • Achilles tendinopathy

  • Biceps tendinopathy

Tendinopathy can affect any area of the body and most commonly affects the elbow, finger, knees, or legs. The pain will usually be felt where tendons attach to the bone.


What does it feel like?

Tendinopathy will be a pain that gets worse when you move and you’ll find it difficult to move the tendon. You may feel a grating sensation when you move and there could be swelling, potentially with heat or redness. This condition can be caused by repetitive or sharp movements.

The pain comes from the damaged tissue inside the tendons. Providing the tendons are not re-aggravated, the tissue will heal or scar in time and stop triggering pain.

Treatment and exercise advice is aimed at preventing aggravation of your damaged tissue whilst encouraging your healthy tissue to become stronger and new tissue to form.


How to manage pain and recover from tendinopathy

It is important to continue using your healthy tissue as much as possible so it doesn’t weaken. We encourage you to continue your activities as much you can, so long as your pain does not become unbearable.

As you work your tendon, it is possible that your pain will reduce as you continue your activity or prescribed exercises. You should reduce the weight or the intensity of your activity if your pain becomes sharp or goes above a moderate level of pain.

If your muscles begin to fatigue or shake before you have completed the exercise you should stop the set, rest, then begin the next set.

After loading a tendon through exercise, it may go through a degeneration process for up to 24 to 36 hours. Then the following 24 to 72 hours, it will go through a regeneration phase, leading to a healthier, stronger tendon.

With this in mind, it is important to remember that your pain post-exercise may be a positive response to treatment.

The way we monitor this is based on how it affects your daily activities and routine. If it is aching after your treatment or loading session, but you are still able to continue your activities then you have had a positive response. However, if you cannot continue your daily activities as you were prior to loading, the chances are you have overloaded the tendon and had a negative response.

If you want expert advice and a tailored treatment plan for your pain, book an appointment with our clinicians. Book an appointment


Isometric exercises for tendinopathy

Isometric exercises are prescribed to increase healthy tissue function.

We suggest doing the following exercises for 35 seconds, repeating three times.


Achilles isometric exercise

This isometric exercise targets the Achilles tendon and calf muscles. It can be helpful in the relief of tendinopathy pain and used during ankle and knee rehab and treatment.


Stand, pressing your bodyweight into the wall. Rise up onto the tiptoes of the affected leg and then lower down so the heel is floating slightly off the floor. Hold this position. Relax and repeat.


Wall sits for patella tendinopathy

This simple wall sit exercise is ideal for dealing with pain from patella tendinopathy and low back problems.


Stand with the back supported against a wall. Bend at both knees, adopting a squat position. Ensure the middle of the knee cap is in line with the outer edge of the feet. Arms are positioned out in front of you. Hold this position. Relax and repeat.


Eccentric exercises for tendinopathy

Eccentric exercises are aimed at increasing the elastic recoil of the tendon.

We suggest six repetitions of these exercises with a four to six-second lowering phase. Rest, then repeat three times.


Calf raise for lower leg tendinopathy

This easy calf raise targets lower leg muscle strains, ankle sprains, and tendinopathy. It can be done on both legs or as a single-leg exercise.


Stand with bodyweight into the wall. Rise up onto both tiptoes. Slowly lower the heels down towards the floor, with control, and then push back up onto your toes- repeat. This can be done on both legs and as a single-leg exercise


Split squat exercise for runners knee

This split squat exercise targets a range of muscles to help provide relief from lower back pain, hip pain, knee pain, tendinopathy, runners’ knee and femoroacetabular impingement.


Stand with one foot in front of the other, elevated on the back tiptoes and turn the rear leg inwards at the hip. Keep the arms positioned out in front of you. Bend at the front knee and hip, allowing them both to flare outwards, and track the rear knee down towards the floor. Imagine drawing a straight line with the rear knee down towards the floor. Keep the back straight, core engaged and let the front knee glide over the outside of the toes as you do this. Breathe normally throughout the exercise. Reverse the movement to resume start position. Repeat.


Remember, if pain persists contact us or book an appointment.

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