The 3 stages of tendon rehab

1. Load Management (Reducing Aggravation, Not Stopping Completely)

At this stage, we modify movement to reduce pain while keeping you active.

• Swap high-impact activities for lower-impact options (e.g., cycling instead of running)

• Use isometric exercises (holding positions) to strengthen tendons without irritation

• Potentially introduce shockwave therapy to help with pain management and stimulation of local blood flow and metabolic activity to support recovery. The evidence for shockwave in different tendinopathy management is variable but if your tendon problem is not responding to loading alone it is definitely worth trying.

• Sports massage to relieve tight muscles that might be overloading the tendon

   

Example: If you have Achilles tendinopathy, reducing running volume while adding calf isometrics helps maintain strength without irritation.

2. Progressive Strength Training (Rebuilding Capacity & Elasticity)

Once pain is under control, it’s time to load the tendon gradually with structured exercises.

• Slow, heavy strength training

• Targeted single-leg work to address imbalances

• Nutrition support, especially protein, is essential for muscle growth, as it helps reduce strain on tendons. Often, tendons are subjected to more load when there are strength deficits in the muscles.

   

Example: A runner recovering from Achilles tendinopathy might do slow heavy strength training and gradual plyometric drills, while also adding extra protein to enhance muscle building.

Refer to February newsletter for more information on the importance of protein and muscle building and Nuzest protein discount code for Wimbledon Physiotheroy:

(Offer 20% with code: WPhysio at checkout)

3. Plyometrics & Sport-Specific Drills (Preparing for Impact & Performance)

In this final phase, we train tendons to handle explosive forces safely.

• Jumping, sprinting, and agility drills High-load explosive exercises (to improve power and resilience)

• Sports Massage sessions to boost recovery & mobility as required can work well

   

Example: A footballer recovering from Achilles tendinopathy would progress from calf raises to sprint drills and agility work. Sports massage prevents tightness, while making sure their nutrition is powering them from within.