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Tendon Pain Tendinopathy Physiotherapy
Tendinopathy is another name for tendon injuries, and these tendon pains and injuries unfortunately can (and will) develop in any tendons all over the body.
It goes by many, many names:
...but really, they all point to the same thing: tendinopathy.
Basically they are tendon injury pathology, so the medical community decided to refer them as tendinopathies (which makes sense).
Typically, tendon injuries occur in three areas:
- tendon insertion (where the tendon attaches to the bone)
- mid-tendon (non-insertional tendinopathy)
- musculotendinous junction (where the tendon attaches to the muscle)
first of all, What is a Tendon Injury?
Tendons are the tough fibres that connect muscle to bone.
They are tough, tough stuff.
injuries occur near joints, such as the
- knee and
(Typically high use, weight bearing or pivoting joints)
A tendon injury may seem to occur suddenly, but usually, it is
the result of repetitive tendon overloading.
What is Tendonitis? is it different?
Tendinitis (or tendonitis): This means “inflammation of
Mild inflammation is a normal tendon healing response to
exercise or activity loading, but it can become too much, where the
rate of injury exceeds your healing capacity.
Tendonitis is the
inflammatory phase of tendinopathy.
An example of tendon injury (in this case, achilles tendon) pathology
The inability of your tendon to adapt to the load quickly enough causes the tendon to progress through four (4) phases of
While it is healthy for normal tissue adaptation during
phase one, further progression and damage can lead to tendon cell death and
subsequent tendon rupture.
1. Reactive Tendinopathy
- Normal tissue adaptation phase
- Prognosis: Excellent.
- Normal Recovery
2. Tendon Dysrepair
- Injury rate > Repair rate
- Prognosis: Good.
- The tendon tissue is attempting to heal.
- You must prevent deterioration and progression to permanent cell death (phase 3).
3. Degenerative Tendinopathy
- Cell death occurs
- Prognosis: Poor
- Tendon cells are dying
4. Tendon Tear or Rupture
- Catastrophic tissue breakdown
- Loss of function.
- Prognosis is inferior.
- Surgery is often the only option at this point (advanced stage)
What is Your Tendinopathy Phase?
It is imperative to have your tendinopathy professionally assessed by Phoenix principal physiotherapists and sports physiotherapists to
identify its current injury phase.
The reason why this is important is identifying accurately is more than
50% of the recovery process - it helps to provide the most direct and
effective treatment as specific
treatment modalities or exercises should only be applied or undertaken
in distinct tendon healing phases.
Systemic Risk Factors
The evidence is growing that it is more than just the tendon and
overload that causes tendinopathy.
There are people who are more at risk to developing tendon-related pains, injuries and tendinopathies such as patients who have / are:
You will need to observe your training
What are the Symptoms of Tendinopathy?
Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.
- The pain may get worse when you use the tendon.
- You may have more pain and stiffness during the night or when you get up in the morning.
- The area may be tender, red, warm, or swollen if there is inflammation.
- You may notice a crunchy / clicking / cracking sound or feeling when you use the tendon.
The symptoms of a tendon injury can be similar or combined with bursitis.
How is a Tendon Injury Diagnosed?
To diagnose a tendon injury, our principal physiotherapists and hand therapists will ask
questions about your
- past health
- symptoms and
- any new exercise regime
We'll do a thorough physical examination to confirm the
diagnosis. They will then discuss your condition and devise an
individualised treatment plan.
They may refer you for specific diagnostic tests, such as an ultrasound scan or MRI
Tendinopathies can typically rehabilitate injured and painful tendons fairly quickly and effectively.
That being said, there are a percentage of tendinopathies that can take months to
As mentioned earlier in this article, it is essential to know what
phase your tendinopathy currently is. Our physiotherapist can assist
not only in your diagnosis but also guide your treatment to fast-track
Before you seek the advice of our principal physiotherapists or hand therapists, you can
start treating an acute tendon injury at home. To achieve the best
results, start these steps right away:
- Rest the painful area, and avoid any activity that makes the pain worse.
- Apply ice or cold packs for 20 minutes at a time, as often as two
times an hour, for the first 72 hours. Keep using ice as long as it
- Do gentle range-of-motion exercises and stretching to prevent stiffness.
When to Return to Sport
Every tendon injury, pain and tendinopathy is different, so please be guided by your
Be patient, and stick with the treatment
exercises and load doses prescribed by your physiotherapist. If you
start using the injured tendon too soon, it can lead to more damage and
set you back weeks!
It may take weeks or months for some tendon injury
to heal and safely cope with a return to sporting load
To minimize re-injuring your tendon, you may require some long-term
changes to your exercise activities. Please discuss this with your
Some factors that could influence your tendinopathy
- Altering your sport/activities or your technique
- Regular prevention exercises.
- Closely monitoring and record your exercise loads. Discuss your
loading with your physiotherapist and coach. They will have some
- Always take time to warm up before and cool down / stretch after you exercise.
While most acute tendinopathies can resolve quickly, persisting
tendon injuries may take many months to resolve.
Long-term or repeat
tendinopathies usually have multiple causes and aggravating factors that contribute to the tendon injury and pain.
These definitely definitely will require a
thorough assessment and individualised rehabilitation plan.
have found that tendon injuries respond differently to muscle injuries
and can take months to solve or potentially render you vulnerable to
tendon ruptures, which can require surgery.
- Tendonitis / Tendinitis
- Overuse Injuries
Foot & Ankle
Hip & Groin
Wrist & Hand
FAQS About Tendinopathy
Acute Injury Signs & Acute Tendon Injury Management.
Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.
For detailed information on specific injuries, check out the injury by body part section.
Don't Ignore these Injury Warning Signs
Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.
If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.
Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.
Reduced Range of Motion
If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.
Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.
Immediate Injury Treatment: Step-by-Step Guidelines
- Stop the activity immediately.
- Wrap the injured part in a compression bandage.
- Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
- Elevate the injured part to reduce swelling.
- Consult your health practitioner for a proper diagnosis of any serious injury.
- Rehabilitate your injury under professional guidance.
- Seek a second opinion if you are not improving.
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Phoenix Rehab Physio Services
Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
PHYSIOTHERAPY & PHYSICAL THERAPY
See all the conditions our principal physiotherapists treat.
HAND THERAPY & CUSTOMIZED SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, usually will benefit / require Hand Therapy to
- manage and decrease hand pains
- improve range of motion, strength and dexterity
- increase the function of their hand
following injuries or post-operations
Commonly treated hand pain injuries includes
REFORMER CLINICAL PILATES & WELLNESS PILATES
Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.
It is a system of safe and effective exercises, which
meet specific individual needs, to treat a wide range of injuries
You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.
TRADITIONAL CHINESE MEDICINE (TCM)
- Cupping TCM
- Auricular Therapy TCM
- Herbal TCM Medicine & Supplementation
DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY
Sports and deep tissue release massage helps to increase nutrient-rich blood
flow to tired, tight and tense muscles to accelerate recovery and shorten downtime / recovery period required.
It also prevents
muscles from scar tissue micro-tears (and potential ruptures), and increases muscle
performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.
Read the benefits of regular deep tissue release therapy here.
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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book an appointment today
(or check your pains / injuries)
Jun 29, 22 08:32 AM
Adele is a registered physiotherapist with over 25 years of experience including treating national athletes as well as recreational athletes having worked in Singapore Sports Council and Singapore Spo…
Feb 03, 22 04:05 AM
Achilles tendon pain is very common among recreational and elite sportspeople. But it is also common among sedentary individuals
Feb 03, 22 12:16 AM
Tendonitis, tendinopathy and tendinosis are all tendon injuries and treated by physiotherapists and hand therapists
Jan 11, 22 02:01 AM
Cervical spondylosis is a general term to describe the degenerative condition in the neck which results in pain and other symptoms
Jan 07, 22 12:28 AM
Tendinopathy (tendon injuries) can develop in any tendon of the body and has many names such as tendinitis and it can be treated with good tendon physiotherapy
Dec 15, 21 01:47 AM
Tendon problems are common in runners and can become a persistent issue if not properly treated.
Dec 14, 21 11:23 PM
Pain and pathology in a tendon, known as tendinopathy, is a common injury in athletes that can be difficult to manage. Physio and hand therapy can help healing
Dec 07, 21 01:31 AM
We use the world’s best tendon recovery programs through cutting edge treatment techniques for all tendon injuries (and tendon injuries differ accordingly)
Nov 28, 21 12:08 AM
Phoenix Rehab Physiotherapy and Hand Therapy at Tampines Singapore
Nov 17, 21 12:30 AM
Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb.