What to expect from strength training rehabilitation for tendinopathy

A physiotherapist first considers the painful area, your movement pattern, current strength, work or sport demands, and how the tendon responds after activity. Exercises may begin with controlled holds or slow movements, then progress to resistance, heavier loads, or activity-specific tasks. Mild, temporary discomfort can occur, but a marked flare that lingers should be discussed so the load can be adjusted. Improvement is usually judged by easier movement, better tolerance of daily tasks, and increasing strength rather than by pain alone.

Follow the agreed schedule and use the technique demonstrated by your therapist. Warm up as advised, keep a record of symptoms after sessions, and avoid adding sudden extra training while the tendon is adapting. Continue useful general activity within your limits, with changes to repetitive or high-load tasks when needed. Home exercises work best when performed consistently; missed sessions should not be doubled without guidance.

Arrange a clinical review if pain is steadily worsening, strength is falling, swelling becomes prominent, or you cannot use the limb normally. Seek urgent assessment after a sudden snap followed by immediate weakness, a visible change in the tendon area, or loss of function. Contact your rehabilitation team if an exercise repeatedly causes a substantial flare so the programme can be reviewed.

Which tendon loads should I pause, and which activities can I continue? How will you increase resistance? What response after exercise is acceptable? When should strength or function be reassessed?