A Working Checklist for Tendon Problems
Tendon Problems: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
Pain and dysfunction in a tendon, commonly the Achilles, rotator cuff or elbow tendons. Tendons respond to progressive loading rather than rest, which is the opposite of what most people do.
Key takeaways
- Main treatment: progressive loading exercise
- 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.
Do
- 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
Do not
- Complete rest, which weakens the tendon
- Repeated steroid injections without specialist advice
- Returning to full load as soon as pain settles
The numbers behind the list
Where the items above come from.
| Measure | Figure |
|---|---|
| Main treatment | progressive loading exercise |
| Timescale | months rather than weeks |
| Rest alone | weakens the tendon further |
| Steroid injection | short-term relief; may worsen long-term outcome in some tendons |
| Common contributor | a sudden increase in training load |
If you change one thing
Load the tendon progressively under guidance rather than resting it. That one first, and the others when you get to them.
Where to go next
- Tendon Problems in Five Minutes
- Tendon Problems: What the Evidence Actually Says
- Tendon Problems — the reference entry
- What the Guidance Really Says About Vitamin D and Bone
- Sports Injuries: What Published Guidance Supports
When to speak to a doctor
Seek urgent assessment 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 raise tendon rupture risk: stop and seek advice for new tendon pain while taking them.
Where this comes from
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, summarised or generalised 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 a GP, 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 999.
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