.png){kind=small}
Understanding Tendinopathy: Why Strengthening is the Best Treatment
- Yannick Sarton
- Jan 23
- 3 min read
Updated: 2 days ago
Tendinopathy is not “just inflammation”
For years, tendon pain was described as “tendinitis,” suggesting a pure inflammatory problem. Research has now clarified that most tendon issues are not driven by inflammation, but by changes in tendon structure and load tolerance.
This explains why anti-inflammatory medication or rest rarely solves the problem — they do not address what the tendon actually needs to recover.
A tendon becomes painful when it loses its capacity to handle load
Tendons are built to store and release energy. When the load they receive suddenly exceeds what they are prepared for — running too much, jumping, lifting, or simply increasing activity too fast — the tendon becomes reactive and hypersensitive.
This reaction is protective, not destructive: the tendon is asking for better load control, not immobilisation.
Rest makes things worse in the long term
Short rest during an acute flare-up is fine. But prolonged rest weakens the tendon further:
• reduced stiffness
• reduced collagen alignment
• reduced energy storage capacity
• increased sensitivity
When patients rest for weeks then return to activity, symptoms usually come back immediately. This is why people feel “stuck in a cycle.”
Why strengthening is the cornerstone of recovery
The only intervention consistently proven to restore tendon capacity is progressive strengthening.
This includes:
• isometrics to reduce pain
• slow heavy strengthening to stimulate collagen organisation
• functional loading to rebuild performance
Strengthening is not optional — it is the treatment.
Tendons remodel slowly, but predictably
Tendon healing is not like muscle healing. It does not follow a 3-week cycle.
Tendon adaptation is slower but extremely reliable when load is progressed correctly.
Most patients see clear improvement within 6–12 weeks, with continued gains up to 6 months.
Pain during rehab is normal — and safe
Many patients worry: “If it hurts, am I damaging it again?”
Modern research shows that controlled pain during strengthening is acceptable and does not cause damage.
The goal is to load the tendon in a monitored, progressive, scientific way, not avoid discomfort.
The takeaway
Tendinopathy is a problem of load, not inflammation.
The solution is to strengthen, not rest.
With a structured program, tendons regain their capacity — and patients return to sport with confidence.
Whether you are in Phnom Penh or abroad, you can book your next in-clinic or online physiotherapy session today.I’m available worldwide for online consultations — simple, fast, and evidence-based.
Explore Studio On — Physiotherapy & Online Care
Physiotherapy & Osteopathy in Phnom Penh (BKK1), offering evidence-based treatments for pain, injuries, mobility issues, and rehabilitation
The Studio
Discover the clinic in Phnom Penh: central location, private room, calm environment, professional equipment.
Overview of the physiotherapy and osteopathy services provided in-clinic: assessment, manual treatment, exercise therapy, rehabilitation.
Detailed information about all conditions treated: back pain, neck pain, joint pain, tendinopathy, muscle injuries, sports injuries, nerve irritation, acute & chronic pain.
Physiotherapy available worldwide: video consultation, diagnosis, personalised rehab plans, follow-up, and exercise programming.
Evidence-based articles helping you understand your condition and take control of your recovery.
Book your physiotherapy session in Phnom Penh or your online consultation in one click.
All the essential details: address, directions, phone number, and opening hours.
Rees JD, Stride M, Scott A. Tendons--time to revisit inflammation. Br J Sports Med. 2014
Patricio Cordeiro TT, Rocha EAB, Scattone Silva R. Effects of exercise-based interventions on gluteal tendinopathy. Systematic review with meta-analysis. Sci Rep. 2024 Feb 9;14(1):3343. doi: 10.1038/s41598-024-53283-x.
Comments