Tendon Pain

Written by Keith Allen-Shirtcliffe 

Many runners have experienced a tendonitis injury during their running careers.  The ‘itis’ at the end of a diagnosis means that the structure in question is inflamed and the immediate treatment would be rest and ice.  The cause of the injury should also be addressed.

The term tendonosis is used when there is a pathology involving the internal structure of a tendon.  It is most commonly seen in a runner over 35 years old where there is degeneration of the Achilles Tendon.  They usually will experience stiffness after rest, being worse in the morning and making the stairs difficult to descend.  Once the tendon is warmed up it becomes less uncomfortable and the athlete is able to continue running.  The problem here is that they will not address the problem because it doesn’t stop them from running, so the tendon gradually gets worse.

It is important to get an expert diagnosis of the tendon.  The Physiotherapist or Consultant will take note of the history and look for some tell-tale signs such as a localised area of tendon stiffness and a fusiform swelling.

Treatment usually involves specific soft tissue mobilisation techniques, some of which can be taught to the runner for self-treatment.  It is also vital to assess the athlete’s biomechanics to eliminate abnormal stresses.  This involves not only their running technique, but also their alignment and control on the affected leg.  Mal-alignment, weakness or ‘collapsing’ slightly on that side would be contributing to this problem.

In addition to exercises specific to that runner’s unique biomechanics it is also important to strengthen the tendon involved.  Your Physiotherapist will prescribe appropriate loading exercises designed to target the Achilles Tendon.  These should be done twice a day and the number done should be increased as able and with the guidance of your Physiotherapist.