Tendinopathy in Runners- by Jess Morrin

Having pain that impacts your running can be frustrating! Tendon pain can be especially difficult, as this type of pain can be very slow in its recovery. Often runners will run through their pain and wait for it to go away, which often will not happen- resulting in a cycle of pain and weakness.

Runners can have tendon pain in the achilles, under the knee cap (patella tendon), in the hamstring tendon (up under the buttock) or in the gluteal tendon (outer hip area).

Tendon pain often presents as pain that warms up or gets better with activity. Tendon pain can feel like a stiffness when your body is cold and can cause a tooth ache type pain at night. In the early stages, you may be able to run through the pain, however, as it gets worse, it will become increasingly harder to run.

So what is a tendon?

A tendon is a thick firm and slightly springy structure that connects our muscles to our bones. Occasionally, if the tendon has been stressed, these tendons can change in their structure. These structural changes can reduce the tendon strength and its ability to take load. When a tendon has changes to its structure that reduces its strength, this is called tendinopathy.

So, what causes these stresses in the tendon? Take a look at the risk factors below

Risk factors for tendinopathy:

  • Changes in training load. Are you training for an event that has increased your load suddenly? Tendons respond to loading, and if the tendon has not been given adequate time to adapt to new loads or increased training, this can cause stress on the tendon resulting in tendinopathy.
  • As we get older, our tendons get older too! This means that the loading capacity and strength of a tendon can diminish a little.
  • Estrogen is an important player in tendon rebuilding, growth and repair, so women who have been through menopause are at risk of tendinopathy.
  • Some antibiotics and cholesterol medications have been known to detriment tendon health. There also may be a link with the long-term use of ibuprophen to tendinopathy, although this is still being explored in the research.
  • Some people have a genetic predisposition to tendon issues so you may notice that you have similar issues to your family members.

How do I treat Tendinopathy?

It is important to see your health professional to discuss the best ways to treat your personal situation, and they can provide pain relief as well! See below for some general guidelines on treating tendinopathy in runners.

Ideas to improve your tendon health:

  • Reduce pain. The first step is to allow the tendon to rest to a point that is pain free. This not only means running but also other aspects of your life, like walking, lifting and strength training. All is not lost though, your physiotherapist can guide you with exercises that load and strengthen the tendon in a positive way, and you can always work on your upper body!
  • Gradual Loading. This is an important phase. You will need to load and strengthen the tendon very gradually, and it will certainly tell you when it is not happy! This phase will often have highs and lows so if you feel like you are going backwards, you need to go back to resting, but often the recovery response is quicker.
  • Don’t stretch it! When the tendon is unhappy, pulling on it is the last thing it needs. If you feel stiff, it is better to massage the nearby muscle, with a massage ball, a foam roller or even your hands! It is best to avoid massaging directly over the painful tendon.

How can physiotherapy help?

  • A physiotherapist can determine if you do have a tendon problem (tendinopathy) with very specific testing
  • A physiotherapist can do a biomechanical assessment to determine why you have developed this problem and start making an action plan forward to help you resolve the issue.
  • A physiotherapist can provided specific exercises to help gradually build on tendon strength that is tailored to your body and your tendon health. Every person is different and not all exercises are suitable for every single body! Exercises need to be specifically prescribed.
  • A physiotherapist can then check all of the factors that can contribute to load on tendons for runners – including foot and shoe assessment, running assessment and biomechanical testing.

Tendon Health at Synergy Physiotendinopathy diagram

At Synergy physio we pride ourselves in our ability to provide thorough assessment and individualised treatment plans. If you are experiencing pain with running, don’t run through it! We can help you get back on track to doing what you love and achieving your running goals sooner.

Do you have outer hip pain thats limiting your running? Check out our NEW online Six Step Healthy Hip Program designed especially for gluteal tendon problems! Click here to find out more!

Contact us by calling 07 54483369 or simply book an appointment with our physiotherapy team online

Learn more about Jess Morrin Physiotherapist Synergy Physio.