Tendinopathy refers to the tendon’s painful or irritating condition, usually brought about by repetitive stress or overuse. Symptoms include pain, tenderness, and swelling in the affected area. It often results from activities that put excessive strain on the tendon or sudden increases in activity levels.
What is a tendon?
A tendon is a tough, flexible band of fibrous connective tissue that ties a muscle to a bone. The force generated by the muscle would be relayed through tendons onto the bones, thereby allowing movement of the body. Tendons are made of closely packed bundles of collagen fibers, which enable them to be strong enough to bear such stresses of activities. As tendons are not as stretchy as muscle fibres, they deal with load differently. Indeed, if put under an intense load, repetitively stretched, or used for repetitive movement, tendons get irritated.
What are the stages of tendon degeneration?
Regardless of age or biological gender, we will all experience some form of tendon degeneration throughout life. The more tendons are used, the earlier the degenerative process will be. In this context, we must reevaluate the negativity of the world’s “degeneration.” So, instead of giving a negative value to this world, let’s consider tendon degeneration only as a process of change in the tendon structure.
This process is made of 3 stages:
Reactive Tendinopathy:
The first stage is characterized by a non-inflammatory reaction with a thickened tendon from increased protein production. The tendon can return to normal if the stress is reduced.
Tendon Disrepair:
If untreated, this is typically the second phase after reactive tendinopathy and is identified by further separation of collagen, disorganization of matrix, increased vascularity, and neural ingrowth. It normally needs to be diagnosed through imaging.
Degenerative Tendinopathy:
This is the final stage, characterized by permanent changes including cell death and marked matrix disorganization; it results in thickened and nodular tendons. Poor prognosis is associated with this condition.
What to do when experiencing tendon pain?
As you start experiencing pain, it is always suggested to reach out to a professional health therapist to evaluate what the problem is. In regards to tendon pain, the first step, independently from which stage of degeneration the tendon is in to, is suggested rest from the movement that flair up the area.
On top of that the usage of heat pack is reccomended for a couple of times a day for 10 to 15 minutes. Tendon have a low blood supply compared to muscles, and the heat applied from outside can help in driving more blood to the area.
Moving forward, if the pain is still present after three days, then the usage of an anti-inflammatory is recommended. The suggestion is to wait 3 days because, in the first three days of pain, the body puts in place what we call the “initial inflammatory response”, a phase in which the body increases blood volume to the area together with other biochemical reactions that kickstart the healing process. If, after three days, the inflammation has not ceased, that’s when the anti-inflammatories are needed.
How do we treat tendinopathy at Melbourne Massage and Treatment?
As a Clinical Myotherapist, I would suggest starting in the early stage with hands-on treatment and exercises-rehabilitation, such as a Myotherapy session. Past the first 3 days of inflammatory response, is good to start looking into why the presentation is not progressing for the better.
Treatment modalities:
Deep tissue massage is a modality that can stimulate relaxation and drive more blood to the area affected.
Myofascial Dry Needling (MDN) can target the muscle attached to the tendon/s. It can help boost a new inflammatory response, desensitise the painful area, and increase muscle activation by interacting with the central nervous system. 
Exercises are then the takeaway for home. In the early stage, we would use isometric exercises to desensitize the area, partially load the muscle and keep the tendon active with constant load. This type of exercise can be used during the 1st or the 2nd week, based on the degenerative process we are dealing with. In terms of the time of load, based on the subjective finding, a time would be outlined. Roughly, we know that we are looking at an isometric load that would last about 30 to 45 secs with a break between one load and the next one, of the equivalent time.
How long could it take to recover fully?
Scientific studies have shown that the recovery process for tendinopathy varies from 3 weeks to 6 months.
This is a big range of time, of course, and it is all about the gravity of the presentation, the tendon location, and the amount of rest that can be achieved along the recovery process.
That said, as per all the exercises, the program is suggested for a minimum of three days a week and a maximum of five days a week. That would give enough time for the structure to be loaded and have time to recover, too.
In conclusion, if you are suspicious of suffering from a tendinopathy, do not hesitate to reach out to Giovanni and Book Now for your next Myotherapy treatment.
FAQ
Q: What is tendinopathy?
A: Tendinopathy is an injury to the tendons and results from repetitive stress or overuse. The result of the tendinopathy is pain, tenderness, and swelling into the affected area. Common activities causing this generally include over-straining or suddenly increasing the level of activity.
Q: What is the degeneration process of the tendons?
A: The tendon degeneration progresses in three stages:
1) Reactive Tendinopathy.
2) Tendon Disrepair.
3) Degenerative Tendinopathy.
Q: What should I do if I have tendon pain?
A: If suffering from tendon pain, basic things that you may try include:
- Rest the tendon from any activities that worsen the pain.
- Apply a heat pack for 10-15 minutes several times during the day as this helps to increase blood flow.
- Anti-inflammatory medication can be considered after three days, as this is typically when the initial inflammatory response has begun to subside.
Q: How do we treat tendinopathy at Melbourne Massage and Treatment?
A: Treatment options for tendinopathy include:
- Deep Tissue Massage: This will help relax and bring blood flow.
- Myofascial Dry Needling (MDN): To address muscles attached to the tendons, enhance a new inflammatory response and promote better muscle activation.
- Exercise: Early-stage treatment includes isometric exercises in order to desensitize and partially load the tendon. Exercises are generally recommended for three to five days a week depending on the severity and site of the tendinopathy.
Q: How much time is required for complete recovery?
A: Complete recovery could take from 3 weeks to 6 months, depending on the severity, location of the tendon, and rest achieved during recovery. An exercise program should be consistent, and to achieve the best results, it should be done three to five days a week.
Giovanni La Rocca
Giovanni moved to Melbourne, Australia, from Italy in 2008 and became a citizen in 2017. He started studying massage therapy in 2016, then completed a Bachelor of Health Science in Clinical Myotherapy in August 2024. During those years, he also specialised in Thai Massage and Manual Lymphatic Drainage for presentations like Lipedema and Lymphoedema. Nowadays, he runs his clinic in Fitzroy North, Melbourne, where he integrates movement therapy into his practice to enhance overall well-being. He also values meditation, having completed several Vipassana courses. Committed to continuous learning, he aims to share his expertise in integrated therapies to help others achieve balance and resilience.