Do you have lower limb tendon pain?

Tendon pain can be debilitating and have a massive effect on your ability to go about your day-to-day activities, let alone go out and exercise.

The medical industry is full of “do’s and don’t’s” when it comes to managing tendons but finally we have streamlined information that suggests these common misconceptions are actually bad for managing tendon pain.

  1. Do not rest completely Resting decreases the ability of the tendon to take load. It is important to find a balance where you reduce loads to the level that the tendon can tolerate and then slowly increase these loads so that the tendon adapts.
  2. Do not have passive treatments Passive treatments do not address the tendons inability to tolerate load. Passive treatments alone, like electrotherapy and ice, will only temporarily reduce or eliminate pain, only for it to return when the tendon is loaded.
  3. Do not have injection therapies Injections of substances, such as cortisone, into a tendon have not been shown to be effective in good clinical trials. Do not contemplate having an injection into a tendon unless the tendon has not responded to a good exercise based program.
  4. Do not ignore your pain Pain is the tendons way of telling the body that the load is too much. It is important to manage the load. reduce the aspects of training that are overloading your tendon.
  5. Do not stretch your tendon Stretching typically only adds compressive loads to the tendon, of which we know are detrimental to the tendon. Stretching while you are standing can be especially provocative to your tendon. If your muscles are tight use massage, foam rolling or trigger point releasing to loosen them.
  6. Do not massage your tendon A tendon that is painful is indicating that it is ‘unhappy’ and irritated, therefore, adding further insult to injury by directly massaging the tendon can actually increase your pain.
  7. Do not be worried about the images of your tendon Pictures of your tendon, whether that be an ultrasound or MRI, can be intimidating and combined with words used by clinicians such as degeneration and tears can make you wonder whether loading a tendon is any good for it at all. There is strong clinical evidence that pathological tendon can tolerate loads, especially when modulated and gradually increased under the supervision of a trained professional.
  8. Do not be worried about rupture Fact – most people who rupture a tendon have never had chronic pain in the tendon before, despite the tendon having substantial pathology in it. Pain is protective of your tendon, it doesn’t mean it will rupture.
  9. Do not take short cuts with rehabilitation Tendons take time! Tendons require a lot of time, consistency, commitment and diligence to build their strength and capacity. Things that are promised as cures generally only give short term improvement and then the pain returns when the loads are resumed.
  10. Do have an understanding of what loads are high for your tendon A tendon is put under its highest stress and load when you use it like a spring, such as jumping, running and sprinting. Overloaded, irritated, painful tendons do not respond well to repeated bouts of high loads.

At Phase 4 Performance & Physiotherapy we have highly trained Physiotherapists who specialise in tendon treatment and management. If you have tendon pain or would like to have a consultation with one of our Physiotherapists please make an appointment online at or call us on 1300 898 414 and speak to one of our friendly administration team who can direct you to the appropriate clinician.

Simon Carlton | Performance Physiotherapist