Tendons connect muscles to bones. They’re composed of collagen fibres which are organized longitudinally along the length of the tendon from top to bottom. Tendons require the ability to withstand, store and deliver force to be able to complete activities. Think of them as “springs” which transfer energy. 

The most common type of tendon injury is tendinopathy. This is associated with overuse resulting in pathological changes in tendon structure and function which leads to pain, diffuse or local swelling, loss of tissue integrity and impaired performance. By overuse, we mean putting too much mechanical stress/load on a tissue and not allowing enough time for recovery.

Tendons take longer to heal compared to muscles, ligaments or bone. Up to 6-12months, less in patients with less severe symptoms and less tendon structure change. The longer healing time is due to changes in vascular, neural and mechanical properties of the tendon when in the painful phases. 

Management depends on the location of tendon pain, the duration of symptoms, and the demands of activities performed. Management will involve an exercise approach, load management and education. Tendons DO NOT respond to rest alone.