Whole body & general Orthopaedic Rehabilitation
Tendinitis & Tendinopathy
- Pain at a specific tendon, worse with loading
- Stiffness after rest, easing with warm-up
- Pain worse the day after activity
- Tenderness and sometimes thickening of the tendon
Quick answer
Tendinopathy is overload of a tendon beyond what it has adapted to, causing pain with loading and stiffness after rest. Despite the "-itis" name, it is rarely inflammatory. It responds to progressive loading over three to six months; rest reduces pain temporarily and weakens the tendon.
Typical recovery
3–6 months
A typical range, not a promise — how long it takes depends on how long it has been going on, and on what you do between appointments.
"Tendinitis" implies inflammation, and for decades treatment followed from that: rest, ice, anti-inflammatories. Tissue studies then showed that persistent tendon pain involves disorganised collagen and failed healing rather than active inflammation. The name stuck; the treatment changed.
The characteristic pattern
Pain localised to a specific tendon. Stiff and sore after rest, easing as you warm up, then worse afterwards and often worse the following day. That 24-hour response is the most useful marker of whether you are loading it correctly.
Common sites: Achilles, patellar (jumper's knee), rotator cuff, tennis elbow, golfer's elbow, gluteal tendons at the hip, and high hamstring.
Why rest fails
Tendons adapt to the load placed on them. Remove the load and they de-adapt — the tendon becomes less capable while the pain settles. Return to activity and it is overloaded again at a lower threshold than before. That cycle is why so many tendon problems run for years.
The treatment
Progressive loading, in stages:
- Isometrics — holding a contraction without movement. Reduces pain and starts loading the tendon when it is too irritable for anything else
- Heavy, slow resistance — the core of treatment. Slow, controlled, progressively heavier
- Energy storage — hopping, jumping and springing, for tendons that need to do that in sport
- Return to the sport or task itself
Some pain during loading is acceptable, provided it settles within 24 hours and is not increasing week on week.
What does not help much
Prolonged rest. Passive treatments on their own. Repeated corticosteroid injections, which give short-term relief and worse outcomes at six to twelve months than exercise.
How long it takes
Three to six months, longer for long-standing cases. Tendons adapt slowly. Loading must continue past the point where pain settles, because pain resolves before capacity does.
Medically reviewed by Pooja Tyagi, BPT, MPT, Orthopaedic Physiotherapy · Last reviewed September 2026