Tendinopathies are common overuse injuries seen in both athletes (e.g. runners) and non-athletes. They are categorised by localised pain through the tendon with loading.
Tendinopathies can develop following increases or high volumes of exercise, or an increase in day-to-day activities that exceed someone’s current level of capacity. People with tendinopathies usually report pain localised to the tendon, and morning stiffness that can sometimes warms up or improves with activity.
Tendinopathies exist in both the lower body and upper body and can include:
The patellar tendon connects your patellar (kneecap) to the tibia (shin bone). Patellar tendinopathy (also known as “jumper’s knee”) is common in sports such as basketball and football due to the jumping nature of these sports. Pain is usually felt just under the kneecap that tends to warm up with activity and then be sore the next day. It can occur due to doing too much and placing an increased load on that tendon that it is not accustomed to.
The Achilles tendon is a common injury seen in runners. The Achilles tendon helps attach your calf muscles to your ankle and is crucial in creating force to allow us to walk, run, and jump. An injury to this area is usually due to an overload or training error. This could be due to doing too much too quickly, changing intensity or load that the tendon isn’t used to, or can occur due to changes in footwear or surface.
The tibialis posterior tendon connects your tibialis posterior muscle to the inside of your foot. If this muscle or tendon becomes overused, it can cause pain through the inside of the foot and ankle. This injury is common in runners and can occur due to an unaccustomed change in load, whether that be due to a change in running/activity load, or changes in footwear or surface that places more demand on the tendon.
The peroneal tendon connects your peroneal muscle into the outside of your foot. When there are changes in the tendon, pain usually is experienced on the outside of the foot and ankle. This type of injury is very common with runners, and can occur due to an increase in activity, changes in footwear or changes in surfaces.
Your gluteal muscles are made up of three muscles, including your gluteus maximus, gluteus medius and gluteus minimus. These muscles form your bottom muscles, and the tendon inserts into the side of your hip. When the tendon becomes sore or overloaded, pain can be experienced on the outside of the hip, or through the back of the hip. Sometimes, you can get referred pain from this type of injury down the outside of your thigh into your knee and can cause secondary knee pain.
The hamstrings sit at the back of the thigh and are important when accelerating and decelerating in running. The most commonly affected tendon is the proximal hamstring tendon, which sits high on the thigh and connects the hamstrings to your sit bone (ischial tuberosity). When this tendon becomes irritated, pain can be felt with things like running, walking, or even sitting down for long periods of time. Although less common, the hamstring tendons around the knee can become irritated, and can occur due to overload. Pain is usually experienced either behind the knee or on the inside of the knee.
The rotator cuff is made up of four muscles – supraspinatus, subscapularis, infraspinatus, and teres minor – which sit on the back of the shoulder around the shoulder blade. Each of these muscles have tendons that connect to the bones around the shoulder. These muscles act as dynamic stabilisers of the shoulder joint. The tendons of the rotator cuff muscles can become irritated when there is either a change in load or an increase in repetitive movements that the muscle/tendon isn’t accustomed to. With this type of injury, pain can be experienced around the shoulder or can be referred down into the arm.
Lateral Epicondylalgia is commonly referred to as “Tennis Elbow” and is when the tendons of the forearm extensors become irritated. Pain is usually experienced on the outside of the elbow, and it can cause weakness in the forearm muscles. Activities that can be particularly aggravating for this type of injury include gripping tasks, repetitive movements such as cutting vegetables, or lifting/carrying things such as the groceries.
Medial Epicondylalgia is commonly referred to as “Golfer’s Elbow” and is when the tendons of the forearm flexors become irritated. Pain is usually experienced on the inside of the elbow and can sometimes cause weakness into the forearm muscles. This type of injury can sometimes cause stiffness in the elbow and pain can be felt with elbow and wrist movements, as well as gripping tasks.
At Complete in Richmond we have world renowned physios leading research on tendinopathy injuries. The clinic has contributed a large volume of tendinopathy research, including the papers listed below.
Due to our expertise, we see a high volume of people with tendon issues, and regularly consult for second opinions or work with other health professionals to guide care, in difficult and challenging cases.
Rehabilitation for some tendinopathies can be long, but with patience and the right guidance, great outcomes are still possible, even in people who have had pain for many months or years. Our Melbourne-based team will work closely with you throughout your journey to support you to get back to things that are important to you.
Rehabilitation of tendinopathy injuries can be a long process and can differ from person to person depending on type of tendinopathy, stage on the continuum and extrinsic (e.g. sport or job demands) and intrinsic (e.g. strength, biomechanics, lifestyle) factors affecting your injury.
The best approach to manage and rehab your tendinopathy can depend on the type of tendinopathy and where it sits on the tendon continuum. Understanding this pathology of your tendon injury can help with your recovery and pain management. Our expert clinicians will assess your current condition, and provide specific guidance to you based on this assessment.
If you have degenerative tendinopathy with associated muscle weakness and wasting, you should see improvements in strength by 3-4 weeks. Improvements in your pain may take longer, up to 6-10 weeks
1-6 months. Depending your goals and initial condition
Possibly, but most people continue to have very mild symptoms even when back to sport and full function
Yes. Unfortunately, tendon injuries are recurrent. Your physiotherapist will discuss strategies to prevent the pain from returning
Yes, some supplements may be helpful. These include Green Tea, L-arginine and fish oils – please discuss further with your physiotherapist
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