If you’ve ever been told to completely rest a painful tendon until it stops hurting, you’re not alone. For years, that was the go-to
advice. However, we now know that complete rest isn’t usually the best solution.
In fact, the right amount of exercise is one of the most effective treatments for tendinopathy. The key is knowing how much is too
much.
Should You Exercise If Your Tendon Hurts?
In many cases, yes.
Current evidence suggests that exercising with mild, manageable pain is both safe and effective during tendon rehabilitation. Rather than avoiding all discomfort, physiotherapists often use a pain-monitoring approach, allowing exercises to be performed within an acceptable level of pain while gradually increasing the load placed on the tendon.
Why Is Loading So Important?
Tendons respond positively to progressive loading. Gradually increasing the demands placed on the tendon encourages it to adapt, become stronger and tolerate everyday activities and sport more effectively.
A progressive rehabilitation programme typically moves through several stages:
● Isometric (static) exercises
● Strength (isotonic) exercises
● Plyometric (explosive) exercises
● Sport-specific drills
Progression is based on your symptoms and function, rather than waiting for all pain to disappear.
How Can Physiotherapy Help?
A physiotherapist can assess your tendon, identify what’s causing the overload and design a rehabilitation programme that safely progresses your exercises. They’ll also help you manage training loads and know when it’s appropriate to increase intensity or return to sport.
The Bottom Line
Pain doesn’t always mean you should stop exercising. With the right guidance, controlled loading is one of the most effective ways to help a tendon recover. The goal isn’t to avoid all pain, it’s to load the tendon safely so it becomes stronger over time.
Newsletter Insight By: Emre Oz (Head of Integrated MSK & Sports Medicine Operations at Crouch Physio/Specialist MSK Physiotherapist).
Reference:
Breda SJ, Oei EHG, Zwerver J, et al. Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy: a randomised clinical trial. British Journal of Sports Medicine. 2021;55:501–509.
