Let's Talk Tendons

What are they, why do they hurt and how can we sort them out?

With the mornings getting lighter, the evenings stretching out and summer slowly making an appearance, more and more of us are shaking off the winter cobwebs and getting back into our favourite activities.

Whether that’s lacing up your trainers for a couch-to-5K comeback, dusting off the gym membership, diving into a padel match or even just getting out in the garden to turn the beds over – we’re moving more. And that’s brilliant.

But with that increase in activity often comes a little sting in the tail… tendon pain.

Now, this isn’t the dramatic sort of injury that stops you in your tracks. No, no, tendon issues tend to be more sneaky than that. They creep in gradually, hang around longer than you'd like and have a nasty habit of flaring up just when you think you've got things back on track.

So in this post, I want to give you the lowdown on tendon trouble – what it is, why it crops up and most importantly, how you can deal with it and keep doing what you love.

What is a Tendon, Anyway?

Let’s keep it simple. Tendons are the sturdy bands of connective tissue that attach muscle to bone. Every time you move – whether you're chasing a ball, jogging along the canal or reaching for a cuppa – tendons are transferring force from muscle to bone to make that movement happen.

They're strong, resilient and designed to handle load… but like most things in the body, they’ve got their limits.

Common Tendon Trouble Spots

Some of the most common offenders include:

• Achilles tendon – back of the ankle/heel

• Patellar tendon – front of the knee

• Rotator cuff tendons – around the shoulder

• Lateral elbow tendon – outer elbow (aka tennis or padel elbow)

• Gluteal tendons – side of the hip

  
  

And here's the kicker: tendon issues don’t always show up with a dramatic “snap” or obvious injury. Like I said more often than not, they creep in – nagging away quietly before turning into something that stops you doing the stuff you enjoy.

What Does a Tendon Injury Feel Like?

Tendon problems can take on many forms. Here's what to look out for:

• A dull ache or stiffness, especially in the morning or after sitting still

• Pain that warms/calms down up with activity, then returns afterwards

• Tenderness if you press the area

• Pain with specific movements or loading

• In more chronic cases – a thickened or swollen tendon area

  
  

A classic example? A runner whose Achilles aches like mad for the first mile, then feels fine mid-run, only to flare up again that evening. Or a padel player who feels fine warming up, then suddenly gets a sharp elbow pain after 40 minutes of backhand smashes, it can be ignored until they really struggle to fill the kettle the next morning for pain.

So, What Causes Tendon Pain?

Tendon injuries are rarely down to one traumatic moment. It’s usually the result of:

Overload (Doing Too Much Too Soon)

This is the big one. Tendons like gradual progress. Suddenly ramping up your running distance or hammering five Padel sessions in a week after months off? That’s a classic recipe for tendon irritation.

Age-Related Changes

Tendons get a bit grumpier with age – especially if you’ve not kept them conditioned.

Inadequate Recovery

Training hard is great – but if you’re not giving your body enough rest, fuel and sleep, tendons don’t get a chance to repair and adapt.

Biomechanical or Technique Issues

Weak hips, dodgy foot control or poor movement patterns can overload certain tendons repeatedly – often without you realising.

What NOT To Do With a Tendon Injury

• Don’t completely rest it for weeks – this often makes things worse

• Don’t rely solely on stretching or massage – it might feel nice but won’t solve the root issue

• Don’t push through “no pain, no gain” style – that can turn a mild irritation into a bigger problem

What Actually Works?

Let’s cut through the fluff – here’s what you really need to do to get on top of tendon pain.

1. Progressive Strength Loading – Your New Best Mate

Forget endless stretching or resting – the cornerstone of tendon recovery is strength.

More specifically: progressive, controlled loading that helps the tendon rebuild its capacity to handle stress.

Start with slow, heavy movements that don’t flare things up (we’re talking about a manageable 2–3/10 pain level during or after). Over time, you’ll reintroduce more explosive and sport-specific movements.

Examples:

• Achilles tendon: Start with slow double-leg calf raises, progress to single-leg, then add plyometrics (e.g. hopping).

• Patellar tendon: Slow squats, step-downs, progressing to jumping drills.

• Rotator cuff: Band-resisted or dumbbell external rotations, then overhead pressing or sport-specific return-to-play drills.

• Elbow (padel/tennis): Eccentric wrist extensions and grip strength work, progressing to racket-based movements.

  
  

2. Modify Your Training, Don’t Ditch It

Total rest? Not ideal. Your tendon will actually become less tolerant to load if you stop using it completely.

Instead, adjust your volume or intensity. That might mean:

• Switching to lower-impact activities

• Reducing frequency of sessions

• Scaling back reps or sets

• Avoiding the most aggravating movements for a bit

  
  

You want to keep moving – just at a level your tendon can currently handle without kicking off.

3. Isometrics Can Help Calm Things Down

Early on, when pain is a bit more acute, isometric exercises (holding a position under tension) can help reduce pain and give your tendon a chance to settle.

These are great for:

• Calming down irritated tendons

• Maintaining some strength

• Helping you bridge the gap between rest and movement

  
  

Examples:

• Wall sits for patellar tendon

• Mid-calf raise holds for Achilles

• Static external rotation holds for the rotator cuff

• Towel squeezes or isometric wrist extension for tennis/padel elbow

  
  

4. Look Beyond the Sore Bit

Tendon pain is often the symptom, not the root cause.

Take a step back and look at how the rest of your body is working:

• Weak glutes or stiff hips? Could be overloading the knees or Achilles.

• Poor shoulder blade control? Might be irritating the rotator cuff.

• Grip too tight or poor wrist control in padel/tennis/golf? Say hello to tennis elbow.

A proper assessment can help identify these weak links and address the bigger picture.

5. Be Consistent (and a Bit Patient)

We get it – no one likes a long rehab plan. But tendons don’t rush. Healing time can range from 6 weeks to several months depending on how long it’s been going on and how consistent you are.

Don’t lose heart if it takes a while. With the right exercises, progression and some tweaks to your training routine, you’ll get there.

Bottom Line? Tendons Can Heal – They Just Need the Right Plan

Tendon pain might be common, but it’s far from untreatable. With the right approach – and a bit of patience – you can get back to doing what you love.

Whether you're battling a cranky Achilles, a dodgy shoulder from padel, or knees that complain every time you hit the stairs – you don’t have to just “live with it.”

Need Help with a Tendon Niggle?

If you're struggling with tendon pain that’s stopping you from training, running, playing or just living comfortably – drop me a message. We’ll work together on a plan that’s tailored to your goals and lifestyle.

DM me on Instagram @RestoreRehabAndPerformance or book a consult via the website. Let’s get you back to moving better, without the tendon tantrums.