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Joint & Movement Health

Tendon Injuries

Pain or reduced function from overuse, overload or injury to a tendon.

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Physician-led assessment · individualized care · Vancouver clinic

Understand this concern|Explore care options
Understand the ConcernA clear medical overview
Physician AssessmentYour concern assessed in person
Care OptionsRelevant options considered after assessment
Personalized CareA plan shaped around your needs

Understanding Tendon Injuries

A problem of load, not inflammation

Tendinopathy hinges on a single concept that overturns the usual instinct to rest: it is fundamentally a problem of load exceeding the tendon's capacity to cope, not simple inflammation. That is why it typically follows a rapid jump in training, repetitive overload or a too-early return, and why prolonged complete rest tends to fail, a tendon deprived of load weakens further. Modern rehabilitation therefore rebuilds capacity through carefully managed, progressive loading rather than avoidance. Age, blood supply and metabolic factors such as diabetes shift the balance, but the governing principle stays the same: the tendon has to be gradually taught to tolerate load again.

Causes and Contributing Factors

Why tendons break down

Tendon problems usually arise when the load placed on a tendon exceeds its capacity to cope and repair. This commonly follows a rapid increase in training or activity, repetitive loading, or a return to activity before full recovery. Age-related changes in tendon tissue, reduced blood supply, certain metabolic conditions such as diabetes, some medications, and biomechanical factors can increase susceptibility. A sudden, high force can cause an acute strain or, less commonly, a partial or complete tear. Tendinopathy is now seen as a problem of tendon structure and load tolerance rather than simple inflammation.

Signs and Symptoms

Typical features

Tendon injuries tend to produce fairly localized symptoms that relate to activity. Common features include:

  • Pain over the affected tendon, often worse with loading or after activity
  • Stiffness, particularly at the start of activity or in the morning
  • Tenderness and sometimes mild swelling or thickening
  • Reduced strength or difficulty with specific movements
  • Pain that may ease during warm-up but return afterward

A sudden painful 'pop' with loss of function can suggest a tear and needs assessment.

Assessment

What the work-up weighs

A clinician typically reviews the activity or change in load that preceded symptoms, the location and behaviour of the pain, and how it affects function. Examination assesses the tendon's tenderness, strength, and response to specific loading tests, and checks nearby joints and muscles. Imaging such as ultrasound or MRI may be used in some cases, particularly if a tear is suspected, though many tendinopathies are diagnosed clinically. A website cannot assess an individual injury.

Treatment Options

Care options for Tendon Injuries

These are some of the options connected to this concern. The appropriate plan depends on assessment, suitability, and your goals.

Because tendinopathy is a problem of load tolerance, the best-evidenced treatment is not rest but the right kind of loading: a physiotherapy-led, progressive strengthening program that gradually rebuilds the tendon's capacity, alongside temporary modification of the activities that overloaded it and attention to the training errors or contributing factors behind it. Recovery genuinely takes time and patience, tendons rebuild slowly, and consistency matters more than any single intervention. A suspected tear is a different problem and may need specific management or a surgical opinion.

Injectable options are often asked about for stubborn tendon pain, including platelet-rich plasma (PRP) prepared from your own blood. The evidence is mixed and varies by tendon, and no injection substitutes for the loading program that does the real rebuilding. For selected people whose tendinopathy has not settled with good rehabilitation, it may be discussed as an adjunct, honestly, and with its uncertain evidence made clear. Corticosteroid injections can ease pain briefly but are used cautiously around tendons, as they may weaken the tissue.

Our approach is to pin down the tendon and the load behind it accurately, set realistic timelines, and build an individual plan with you, physiotherapy-led, with adjuncts considered only where they genuinely add value, and referral arranged when needed.

For the fuller picture, explore the treatment pages above or discuss the options during a consultation.

Clinical perspective

Tendinopathy is treated here as a loading problem, not an inflammation to be rested away. A progressive, physiotherapy-led strengthening program is the best-evidenced treatment for the great majority of tendon problems, and it is where care starts and remains centred. Corticosteroid injections are used cautiously because they can weaken tendon tissue, and PRP is offered only as a considered adjunct for tendinopathy that has not settled with good rehabilitation, never as a substitute for the loading program that does the actual rebuilding.

Evidence & references

Selected sources informing this page. Canadian guidance is prioritised, and manufacturer materials are not treated as independent clinical evidence.

  • British Journal of Sports Medicine: reviews on tendinopathy management and progressive (load-based) rehabilitation.
  • Cochrane Musculoskeletal: systematic reviews of loading/eccentric exercise for tendinopathy.
  • Coombes BK, et al.: efficacy and safety of corticosteroid and other injections for tendinopathy.
  • Platelet-rich plasma (PRP) for tendinopathy: evidence is mixed and tendon-specific.

Medical Assessment

When not to wait

Prompt assessment is important if there is a sudden painful pop with loss of strength or function, marked swelling or bruising, an inability to move or bear weight, or a visible gap or deformity, as these can indicate a tendon tear. Pain that is severe, rapidly worsening, associated with fever or redness, or not improving despite appropriate rehabilitation also warrants review.

Frequently Asked Questions

Questions about Tendon Injuries

Prolonged complete rest is usually not the best approach for tendinopathy, as tendons generally do best with gradually progressed, guided loading that rebuilds their capacity. Aggravating activities may be modified temporarily, but a structured rehabilitation program is often central to recovery.

Tendons rebuild and repair slowly, so recovery commonly takes weeks to months and can feel slower than expected. Consistent, appropriately progressed rehabilitation and avoiding repeated overload are important. If there is no improvement despite this, a reassessment is reasonable.

A sudden painful pop, marked loss of strength or function, significant swelling or bruising, or a visible gap can suggest a tear and needs prompt assessment. Tendinopathy more often causes gradual, activity-related pain and stiffness. A clinician can distinguish these and arrange imaging if needed.

Current thinking is that tendinopathy is mainly a problem of tendon structure and its ability to tolerate load, rather than simple inflammation. This is why management emphasizes progressive loading and addressing training factors rather than relying on anti-inflammatory measures alone.

Platelet-rich plasma (PRP) is sometimes offered for persistent tendinopathy, but the evidence is mixed and varies by tendon, and it is not a reliable fix on its own. The best-evidenced treatment remains a progressive loading (strengthening) program, and any injection is best thought of as a possible adjunct for selected cases rather than a replacement for that work. Suitability is decided after assessment.

Physician Assessment

Discuss Tendon Injuries with our medical team.

An assessment can help clarify what may be contributing, which options may be appropriate, and what a reasonable next step could look like for you.

Book a ConsultationCall (604) 261-9121
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