How effective is physiotherapy for tendinopathy?

Tendinopathy describes a tendon that is not tolerating its current combination of load, recovery and movement demands. Physiotherapy usually focuses on progressive strengthening rather than complete rest. The programme may begin with isometric or slow resistance work, then advance to heavier, faster or sport-specific loading. It can also address joint movement, technique, work setup, footwear and the pattern of training. Pain may fluctuate while capacity improves, so function and next-day response matter alongside pain intensity.

Use the exercise dose provided by your therapist and keep the load regular rather than alternating between overdoing activity and stopping completely. Reduce the most provocative task temporarily, then reintroduce it in measured stages. Record symptoms during exercise and the following day. Tell the therapist about swelling, a sudden change in pain, a snap, bruising or a clear loss of strength, because these features need a different assessment.

Seek prompt care after a sudden pop with bruising, a visible change in the tendon’s shape, inability to push off or lift the affected part, or rapidly increasing swelling. Arrange review when pain is worsening despite load adjustment, limits sleep or ordinary movement, or has not improved as expected. A different diagnosis or additional treatment may need consideration.

Ask which tendon actions to train, how much discomfort is acceptable, how to progress resistance, how to modify work or sport, and what signs suggest a tear rather than tendinopathy.