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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

Understanding tendon injuries

Maybe your Achilles is stiff for the first few steps every morning, or your knee aches at the start of a run, eases off, then grumbles again afterwards. That pattern is classic for a tendon that's been asked to do a bit more than it was ready for, and it's very treatable.

Tendinopathy usually happens when the load on a tendon outpaces its ability to cope, often after a jump in training, lots of repetitive work, or getting back to sport a little too soon. It's less about inflammation and more about the tendon's capacity, and a tendon without load gets weaker. What works is carefully managed, progressive loading that teaches the tendon to tolerate work again. Age, blood supply and conditions like diabetes can affect how quickly that happens, and we factor them into your plan.

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Causes and Contributing Factors

Causes and contributing factors

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 understood mainly as a problem of tendon structure and load tolerance, with inflammation playing a smaller part.

Signs and Symptoms

Signs and symptoms

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

Your tendon assessment

Your assessment is with Dr. Teri Fisher, our sports medicine physician. No referral is needed, and it helps to share your most recent imaging or reports before your appointment.

Dr. Fisher asks what changed in your activity before the pain started, exactly where it hurts, how it behaves, and what it's stopping you from doing. She then checks the tendon for tenderness, strength and how it responds to specific loading tests, and looks at the nearby joints and muscles. Ultrasound can help when a tear is suspected. From there you'll have a step-by-step recovery plan that fits your sport, your work and your timeline.

Sports medicine consultations are physician appointments with a consultation fee, confirmed when you book.

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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.

Our sports medicine service treats tendons in the shoulder, elbow, wrist, knee, ankle and foot, including the Achilles, patellar, rotator cuff and elbow tendons. Hip and spine concerns are outside our service, as our ultrasound system doesn't support these areas.

The best-evidenced treatment is the right kind of loading: a physiotherapy-led, progressive strengthening program that gradually rebuilds the tendon's capacity, while you temporarily ease off whatever overloaded it and we work on the training habits behind it. Tendons rebuild slowly, so steady, consistent work matters most. A suspected tear is a different situation and may need specific management or a specialist opinion.

People often ask about injections for stubborn tendon pain, including platelet-rich plasma (PRP) prepared from your own blood. The evidence is mixed and varies by tendon, and the loading program does the real rebuilding. For selected people whose tendinopathy hasn't settled with good rehab, PRP may be discussed as an add-on, with the evidence explained clearly. Corticosteroid injections can ease pain briefly but are used cautiously around tendons, as they may weaken the tissue.

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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 most tendon problems, and it's where care starts and stays centred. Corticosteroid injections are used cautiously because they can weaken tendon tissue, and PRP is offered only as a considered add-on for tendinopathy that hasn't settled with good rehabilitation, always alongside the loading program that does the actual rebuilding.

Evidence and references

Selected sources informing our approach. Canadian guidance is prioritized, 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 to see a doctor

Prompt assessment is important if there's 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 point to a tendon tear. Pain that's severe, rapidly worsening, comes with fever or redness, or isn't improving with good rehabilitation also needs review.

Frequently Asked Questions

Questions about Tendon Injuries

Long spells of complete rest usually aren't the best approach for tendinopathy, because tendons do best with gradually progressed, guided loading that rebuilds their capacity. Aggravating activities may be eased off for a while, and a structured rehab program sits at the centre of recovery. Tendons rebuild slowly, so if things aren't improving, a reassessment is worthwhile.

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. An examination tells them apart, and we can arrange imaging if it's needed.

Platelet-rich plasma (PRP) is sometimes offered for persistent tendinopathy, but the evidence is mixed and varies by tendon. A progressive strengthening program remains the best-evidenced treatment, and an injection is a possible add-on to that work for selected cases. Your physician will tell you after assessment whether it suits you.

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.

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