Tendinopathy Truths

By Damian Cocciolone

Tendinopathy- refers to a breakdown of collagen within a tendon tissue and a failed healing response.

The term tendinopathy is a generic descriptor of the clinical conditions ( both pain and pathological characteristics) associated with overuse in and around tendons.



  1. 1.Rest is not the answer! Whilst relative rest (avoidance of aggravating factors), modification of training or lifestyle factors are often a necessary part of the management for tendinopathy. Time and rest alone do not result in improvement of the tendon tissue quality or improve the tendons ability to tolerate load. 



  1. 2. Exercise is always part of the answer. Tendons need mechanical stress/load in order to remodel/heal. There is a large evidence base that demonstrates exercise as being superior to other forms of treatment for tendinopathy. Unfortunately just as healthy individuals respond differently to exercise so do individuals with tendinopathy.



  1. 3.Tendons come in many shapes and sizes and they serve different purposes based on these anatomical differences. Some tendons are short and flat with a large cross sectional area designed for stability e.g rotator cuff tendons. Some tendons are long and thick designed to transmit high levels of force/act like springs e.g Achilles’ tendon. Given this there is no one size fits all treatment for tendinopathy.



  1. 4. Components of a quality rehabilitation program. Your rehabilitation program needs to be individualised taking into account the type of tendon involved, chronicity of the injury, age, sex, goals of rehabilitation,  it should be progressive in loading demands and intensity. Involve exercise that leads to heavy resistance training and plyometric/sports specific training (if athletic endeavours are a goal).