What it is
Tendinopathy is a tendon that has been asked to do more than it can currently tolerate. It is not usually inflammation, which is why rest alone rarely fixes it – the tendon needs to be reloaded, carefully and progressively.
The Achilles, patellar, gluteal and rotator cuff tendons are the most common sites, and the pattern is similar: pain that warms up with activity, returns afterwards, and is worse the next morning.
Symptoms
- Localised pain over the tendon, often tender to press
- Stiffness first thing, easing with movement
- Pain that returns after activity rather than during it
- A sense the area is “not strong enough” to trust
How it is assessed
Treatment options
The foundation is a loading programme – the evidence for this is stronger than for any injection. Where symptoms are stubborn, options discussed in consultation include radial shockwave therapy and, for selected patients, platelet-rich plasma or prolotherapy. Corticosteroid injections are used sparingly around tendons and only where there is a clear reason.
Responses vary between people. Suitability for any injection is assessed individually and explained honestly, including when the right answer is no injection at all.
When to seek help
- Pain that has lasted more than six weeks despite reduced activity
- A sudden “snap” or loss of strength - a possible tear
- Night pain, swelling or redness
- Pain that is stopping you training or working
DECIDED IN CONSULTATION