Tendon Problems: Separating Myth From Guidance
Tendon Problems: what people commonly get wrong, set against what published US guidance says.
Tendons respond to gradual, progressive loading rather than rest, which is the opposite of what most people do.
Key takeaways
- Main treatment: progressive loading exercise, often with a physical therapist
- Timescale: months rather than weeks
- Most useful single change: Load the tendon progressively under guidance rather than resting it.
- Commonest mistake: Complete rest, which weakens the tendon.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
What the guidance actually says
These are the numbers the corrections below are measured against.
| Measure | Figure |
|---|---|
| Main treatment | progressive loading exercise, often with a physical therapist |
| Timescale | months rather than weeks |
| Rest alone | weakens the tendon further |
| Steroid injections | short-term relief; may not help, or may harm, in the long run for some tendons |
| Common contributor | a sudden increase in training load |
Where people go wrong
What people tend to think, set against what is actually published.
- Complete rest, which weakens the tendon
- Repeated steroid injections without advice from a sports medicine or orthopedic doctor
- Returning to full load as soon as pain settles
What to do instead
- Load the tendon progressively under guidance rather than resting it
- Expect improvement over months and keep going
- Reduce but do not stop activity while rehabilitating
- Address the training error that caused it
The part that is genuinely uncertain
Guidance changes, and it changes because evidence does. The figures above reflect current US guidance from the bodies named at the foot of this page; where those bodies revise their position, theirs is the account to follow rather than this one.
Related topics
- Plantar Heel Pain: Sorting the Evidence From the Noise (Foot Health)
- Running for Beginners: What Published Guidance Supports (Fitness)
- What the Guidance Really Says About Returning to Activity After Illness (Rehabilitation)
- Neck Pain: What the Evidence Actually Says (Back and Posture)
Where to go next
- Tendon Problems in Five Minutes
- Tendon Problems: What the Evidence Actually Says
- Tendon Problems — the reference entry
- Bone and Joint: The Complete Guide
- What the Guidance Really Says About Vitamin D and Bone
- Sports Injuries: What Published Guidance Supports
When to speak to a doctor
Seek prompt care at urgent care or the emergency room for a sudden sharp pain with a pop or snap, an inability to push off or raise the arm, or a visible gap in the tendon — these suggest a rupture. Fluoroquinolone antibiotics such as ciprofloxacin carry an FDA warning for tendon rupture: contact your doctor right away about new tendon pain while taking them. Call 911 for a serious injury with severe pain, deformity or inability to move the limb.
Where this comes from
- FDA — FDA Drug Safety Communication: FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects
- MedlinePlus — Tendinitis
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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