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Tendinopathies

Updated: Jan 31


How to assess Tendons


The role of a tendon is to transfer force from muscle to bone, it plays an essential role in the elastic recoil to return energy during movement with great efficiency. Anyone who runs, jumps, kicks or throws can be affected by tendon issues. It is not limited to sports and recreation and can also be a work related issue.


Almost any tendon can become painful whether it is the Achilles, Patella, Gluteal, High Hamstring, Adductor in the groin or Tennis elbow. A common theme that links all tendon pain is ‘load’, hence managing a ‘tendinopathy’ can be challenging.


Tendinopathy Continuum

Tendons love homeostasis and any variance from a normal routine can trigger a reaction. The reaction is suggested to lie within a continuum from normal tendon through to a degenerative tendon and even reactive-on-degenerative tendon.


Risk Factors

  • Increased training stimulus following a period of inactivity (after a holiday)

  • Rapid change in training volume (preparing for a race)

  • A change in Footwear

  • Change in play surface (out door grass to harder indoor surface during tennis season)

  • Increase repetition in manual work / over head lifting (repetition line workers)

  • Age

  • Weight

  • Previous History


Clinical Presentation

  • Patient can report pain on muscle contraction

  • Patient can report weakness

  • Patient can report pain with specific activities that load the effected tendon

  • Patient can report morning pain & stiffness

  • You may note high levels of pain on palpation of the tendon

  • You may note pain on isometric and functional muscle testing

  • You may note pain on stretching the tendon

  • The tendon may be thickened / swollen compared to the unaffected side


Example Assessments - Videos Coming soon


Achilles Tendon



Patella Tendon



Gluteal Tendon



Adductor Tendon


High Hamstring Tendon



Tennis Elbow






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