25th April 2019

Tendon pain is a very common diagnosis we see here at the practice. Whether it is the patellar tendon (below the knee cap) or the Achilles Tendon, or even the hamstring tendons. These are the most common ones we do see in the clinic.

Tendons usually respond to a change or increase in load which is why they flare up and cause pain. Sometimes an increase in your desired sport or activity that is too quick or even changing activity altogether can cause a bit of an irritation in the tendon matrix itself. For example, getting knee pain in the front of your knee after running 5 KM’s when you usually cycle as your preferred activity, is usually the starting point for us to diagnose a Tendinitis.


Along with the load response, there are a few symptoms that help us diagnose Tendon related inflammation:

  • Pain at the specific site of the tendon, tendons very rarely refer pain to any other area and often patients can pin point the site of irritation on the tendon itself;
  • Pain before and after activity: Usually with exercise tendon pain simmers down but starts to hurt once you cool down again;
  • Any signs of Inflammation: Swelling, hotness, throbbing and redness of the tendon can show an acute flare up of the tendon;
  • Usually a describable sharp/pin point pain and then a dull ache 1-2 days after the flared-up activity has taken place.


Now, once we diagnose you with a tendonitis, what do WE do? Well treatment is essential for the tendon to go away. The common thought is that it usually disappears with rest. Which of course, the pain will go away if you don’t flare it up, however, it will just return if you return to that activity. So, this is what we do.


  1. Initially we get rid of inflammation

This is essential to start any treatment process as inflammation causes a lot of pain and irritation for you, and we want to stop this as quickly as possible. This can be done through a variety of techniques:

  • Icing
  • Taping to Unload the Tendon
  • Relative Rest to avoid further aggravation
  • Manual therapy
  • Acupuncture
  • Anti-inflammatory medication


  1. Relative Rest and the very CRUCIAL; Loading the Tendon

You may ask, what is relative rest? Well this is resting from your current activity that would cause a tendon flare up, and substituting it with another desired activity that doesn’t cause pain, i.e. switching from running to cycling or even swimming. We can start loading the tendon slowly to begin rebuilding it to withstand more load. We would start slowly loading it over the next coming treatment sessions to prevent it from flaring again and making it strong enough while preventing another flare up – it’s also important to note, tendons love to respond within a 24 hour pattern, so this is a great time marker to figure out if we are loading the tendon too much or too little during our rehab program, which we keep close tabs on to hit that sweet spot in the loading phase early. Yes, we are pro active J


  1. Return to YOUR Activity

Once your tendon has gone through the correct sequence of strengthening techniques, we can now start loading the tendon back slowly towards your desired sport and activity, within this stage we would also strengthen any other dysfunctions we found on our assessment, which may have aided in causing the problem in the first place. We would start slow, initially and slowly build you back up to get you active pain free once again!

Our treatment plans are goal driven, and when we say ‘goal driven’ we mean driven by YOUR goals. We are high achievers, and we want you to do all the things you love in life, so we are here to help you.



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118A London Wall, EC2Y 5JA

We are based on London Wall, City of London, moments away from a few of the main underground stations. Our closest tube stations are: Moorgate, Liverpool Street and Bank stations.


Opening Hours: Mon: 7am – 1pm | Tues: 1pm - 8pm | Wed: Closed | Thurs: Closed | Fri: Closed | Sat & Sun: Closed
Emergency appointments may be available outside our opening hours.

020 737 484 92