Tendon pain

Treat it within 6 weeks!

Tendon problems are reversible if you deal with them early.  If your muscles and tendons start being used in a way they weren't designed to be used then at some point you might be saying "hello tendinopathy."  For some it can be a mild problem that doesn't last that long, for others it can really be painful and a tough condition to get on top of. Tendon problems respond well to treatment within the first 6 weeks of symptoms starting, that's why it's best to get on top of it sooner rather than later and it makes the lives of us therapists much easier!

Tendons need to be strong, tough and fibrous as their job is to attach muscle to bone and absorb energy/impact.  Overloading the tendon can cause small microscopic tears and swelling within the tendon fibres. Initially this is reversible. With time the tendon collagen fibres will breakdown and become a long-term problem. Permanent thickening of the tendon fibres occurs, with nodules, stiffness and risk of larger tears or rupture.

Common symptoms

  • Pain directly over the tendon
  • Pain is often at rest eg first thing in the morning
  • Pain after exercise
  • Pain can often be better during sport when the muscle has warmed up

Common causes

  • Increasing training / activity levels
  • Reducing the amount of rest days
  • Change in activity
  • Injury or trauma
  • Poor sport technique
  • Over-use e.g repetitive strain at work


Treatment really depends on the stage your tendinopathy is at.  It will differ in the reversible "reactive" stage to the "disrepair" and "degenerative" stages.  To complicate things you could have more than one stage going on at a time, but it's our job at Emsworth Osteopaths to deal with that!  It's useful to note what aggravates symptoms, even up to 2 days after an activity. Treatment is about correcting the factors that caused the tendinopathy and can include:-

  • Reduce activity /training levels 
  • Change activity to reduce load exercise e.g bike, swim
  • Adjust activity e.g run in the evening rather than morning
  • Rest up to 3 days after exercise
  • Exercises to specifically load the tendon to make it stronger 
  • Stretches, if advised
  • Massage
  • Foam roller the muscle (rather than tendon) to improve flexibility
  • Anti-inflammatories (can help in reducing proteins production that causes swelling)
  • Acupuncture for pain relief


Wrist and/or elbow tendon injuries can be common with frequent mouse and computer use. If the muscles around the shoulder blade are not strong and balanced then the shoulder can hunch forwards and the upper arm turns inwards. To adjust for this whilst reaching the mouse the forearm turns outwards placing pressure on the elbow and wrist muscles. Altering your biomechanics starts tendons and muscles and being used in a way that they weren't designed for and their engineering breaks down.