Get your tendon loading properly again

Tendons have a much lower blood supply than muscle and a slower rate of collagen turnover, so the tissue rebuilds gradually. Muscle strains often feel better within a couple of weeks, while a tendon rebuilding its capacity to store and release load usually needs a longer, steadier program. That is why consistency with your exercises matters more than intensity in any single session.

Yes. Some antibiotics in the fluoroquinolone family, such as ciprofloxacin, are linked with tendon pain and, rarely, tendon rupture. Long courses of corticosteroids and some cholesterol-lowering medications have also been associated with tendon symptoms. Do not stop a prescribed medication on your own. Tell your practitioner what you take, and raise any new tendon pain with your GP.

Anti-inflammatories may take the edge off pain in the first days after a flare, but they do not rebuild the tendon. Persistent tendon pain usually involves structural change rather than active inflammation, so tablets often make little difference after the early stage. Talk to your GP or pharmacist about whether they suit you, and use them alongside a loading plan rather than instead of one.

Most tendon programs allow pain up to about 3 or 4 out of 10 during exercise, provided it settles within 24 hours and is no worse the next morning. Pain that spikes higher, lingers into the following day or leaves you stiffer than usual is a sign the load was too much. Your physiotherapist sets your own threshold at the assessment.

It can. When more than one tendon becomes painful without an obvious load spike, health factors are often involved: type 2 diabetes, high cholesterol, thyroid conditions, inflammatory arthritis or hormonal changes around menopause. Your practitioner will ask about these and may suggest you see your GP for blood tests. Addressing them alongside your exercise program supports how the tendon responds.

Growing children more often develop pain where a tendon attaches to a growth plate rather than in the tendon itself. Sever’s disease at the heel and Osgood-Schlatter disease at the knee are the common examples, and both usually follow a busy sports season. They are managed differently to adult tendon pain, so book an assessment rather than assuming it is the same problem.