Tendinitis (Tendinopathy): what it is & what actually works to treat it

Tendinitis, more accurately called tendinopathy, is a condition where a tendon (the tissue connecting muscle to bone) becomes painful and less tolerant to load. Modern research shows most long-lasting cases are not driven by classic inflammation, but by impaired tendon adaptation due to excessive or rapidly increased loading.

Why it happens

Tendons adapt more slowly than muscles. Sudden increases in training volume, intensity, jumping, sprinting, or returning too fast after time off are common triggers. Poor recovery (sleep, nutrition, stress) increases risk.

How to prevent it

• Progress training gradually

• Strength train consistently year-round

• Avoid sharp spikes in volume or intensity
  Recent meta-analyses show that higher-load resistance training with adequate recovery improves tendon capacity and reduces injury risk.

How to treat it (evidence-based)

The strongest evidence from recent PubMed systematic reviews and meta-analyses supports progressive tendon-loading exercise as first-line treatment.

• Isometrics can reduce pain short-term

• Heavy slow resistance improves pain and function

• Eccentric exercise is effective, especially for Achilles tendinopathy

Bottom line

Tendinopathy isn’t fixed by rest alone. The goal is progressive, well-managed loading that rebuilds tendon tolerance over weeks to months—not quick fixes.