Tendonitis: what it is and how to treat it

Rehab physio Juliet Slade explains all you need to know about tendonitis including causes, symptoms, treatment and prevention

Tendonitis often affects the Achilles tendon in the ankle. Credit: Catinsyrup / Getty Images

What is tendonitis?

Pain or aggravation in a tendon that causes an associated impairment in performance is characterised as tendonitis, and commonly affects the Achilles and tendons of the patella, shoulders, elbow and wrist.


What’s the difference between muscles, tendons and ligaments?

 Achilles tendon injuries: how they happen and how to prevent them


What causes tendonitis?

Both internal and external factors can contribute to tendonitis. We know that it’s an overuse injury, therefore the majority of the time there’s an external change in load to the tendon that becomes excessive. Whether that’s an athlete increasing their weights too quickly, or pushing training intensity/duration. Or a desk worker required to work longer hours and therefore using more repetitive motions with the keyboard/mouse than usual.

Tendonitis commonly affects people over the age of 40 when tendons can develop degenerative changes altering their collagen make-up and blood supply and exposing them to higher risk of irritation. It’s often more commonly reported in men.

What are the symptoms of tendonitis?

Tendonitis will present with tendon pain. There may be associated swelling and heat due to inflammation. Activities requiring the use of the affected area will become sore and may feel weak to perform. Pain can be noticeable at night due to its inflammatory nature and interfere with sleep.

How do you treat tendonitis

Initial treatment for tendonitis is to restrict the load on the tendon to prevent overuse, e.g a runner must stop running on an Achilles tendinopathy but will still load with walking. It’s then essential during this rest period to assess and address the cause of aggravation. Otherwise, when the runner returns to running the issues will still be present. A physiotherapist can identify areas of stiffness and weakness inhibiting performance. e.g a runner increasing distance for marathon training may not have the glute and calf strength to do so, thereby overloading the Achilles.

Why is glute strength important?

Isometric strength exercises can help ensure the tendon itself stays strong without causing irritation. Then the previous aggravating activity can be gradually reintroduced to monitor tendon load capability. This prevents it from weakening during the rest and conditioning period. You may also be prescribed anti inflammatories and ice to reduce pain and inflammation.

How can you prevent tendonitis?

It’s imperative to keep your body well-conditioned. Anyone looking to progress their training should do so periodically to allow their body to adapt. It’s important to remember to think out of the box – runners shouldn’t just run. Mo Farah will lift heavy weights twice a week to keep his body strong and stimulate further growth for progressive training.

Quality technique is also key to ensure load is distributed consistently well through the body.

Incorporate 1-2 mobility sessions a week to enable quality movements and correct recruitment of muscles. Stiff muscles aren’t happy ones!


 Juliet Slade is a rehab physiotherapist at Six Physio

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