Your tendons are the strong elastic pieces of tissue that connect your muscles to the bone and allow them to create movement, when these tissues get overloaded, they can cause pain similar to many other structures in your body. Tendinopathy is a term used to describe a tendon that is painful or not functioning well and includes but is not limited to Tendinitis, Tendinosis and Interstitial Tears of the tendon. These can all be thought of as small micro-tears within your tendon.
In the early stages of tendon related pain, sometimes medications such as anti inflammatories or cortisone injections will help reduce the pain. Unfortunately this doesn’t mean they are a good choice to manage your pain as they do not address the underlying cause. As mentioned, tendons become painful due to being overloaded; their capacity is being exceeded. To ensure that a tendon issue continues to improve and reduce the risk of the pain returning two major things are required. You need to reduce the harmful load and you need to begin strengthening the tendon in a graded way to re expose it to the load.
To decide what the harmful load is for your tendon your therapist would take a full history to understand the activities you undertake and enjoy, and educate you on how to modify them for the short term, as well as instruct you on measures you can take to start building up the strength and capacity of the tendon. It is important to be mindful that complete rest isn’t a great solution for tendon related pain. It will begin to feel better but if you don’t build the capacity of the tendon and you return to your previous activities the pain will likely return quite quickly.
Tendinopathy changes are unlikely to heal which is another reason why appropriate strengthening is so effective. When the tendon is loaded appropriately you gain more healthy tendon around the micro tears and the tendon becomes strong enough to keep you going with the activities you enjoy.