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What are tendon overload injuries?

Updated: Apr 15

An image of a physiotherapist assessing a patient's knee and leg mobility

What are tendons?

A tendon is a tough band of fibrous connective tissue that connects the muscles to the bones and are capable of withstanding tension.

Tendons are made up of collagen fibres and their role is to transmit the forces generated by muscles and distribute those forces to the skeletal system.

Unlike muscles, tendons have poor blood supply and therefore can be slow to recover once injured.

How do I injure a tendon?

Tendons are prone to injury when training loads or the forces placed through them are suddenly changed or the load exceeds the tendon’s capacity to deal with that load, leading to breakdown of the collagen fibres.

These injuries can occur throughout the body, but some of the most common tendon injuries occur in the;

  • Rotator cuff in the shoulder. The rotator cuff helps to lift and rotate the arm and to stabilise the ball of the shoulder within the joint.

  • Elbows. Also commonly referred to as Tennis / Golfer’s elbow. Golfer's elbow is where the tendons of the forearm muscles attach to the bony bump on the inside of the elbow. By contrast, tennis elbow usually occurs at the bony bump on the outside of the elbow.

  • Knees. Also known as jumper’s knee. This refers to overuse injury that results in pain at the front of the knee, localised at a point towards the bottom of the kneecap.

  • Achilles. The Achilles tendon or heel cord, is a tendon of the back of the leg, and the thickest in the human body. It serves to attach the calf muscles to the heel bone.

  • Ankle. The two peroneal tendons in the foot run side by side behind the outer ankle bone. One peroneal tendon attaches to the outer part of the mid-foot, while the other tendon runs under the foot and attaches near the inside of the arch.

By the time tendons become painful the underlying process that has resulted in the pain has often been going on for some time. This is why tendon pain can develop days, weeks or even months after aggravating activities.

What causes tendon injuries?

Some of the common causes of tendon injuries occur due to overtraining and training error. The “yo-yo-ing” exercise patterns that involve periods of inactivity followed by large increases or sudden intense training are a common cause of tendon injury seen in the clinic.

The other common cause of tendon injuries occur when a person is doing a new/unexpected repetitive activity or task around the house such as painting, cleaning a large area, lifting/carrying etc.

What do I do if I have/suspect a tendon injury?

The way tendon injuries are managed is different to muscle or bone injuries so it's important to see a physiotherapist for a thorough assessment and for an individually tailored rehab plan. The degree of injury will affect your treatment plan as well as the place of the injury.

To book an appointment with Sally Blake or another of our physiotherapists click here.

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