5 Common Tendon Injuries (And How Physiotherapy Can Help)

What are the most common tendon injuries?
The most common tendon injuries include elbow tendinopathy, gluteal tendinopathy, proximal hamstring tendinopathy, patellar tendinopathy, and Achilles tendinopathy. These injuries are typically caused by repetitive overload or a sudden increase in activity.

With the right rehabilitation approach, tendons can respond well to progressive loading and structured physiotherapy.

Tendon injuries are some of the most common conditions we see in the clinic, affecting runners, gym-goers, and active individuals.

Tendons are strong bands of connective tissue that attach muscle to bone and play a key role in transmitting force. This allows us to walk, run, jump, lift, and generate power.

Despite their strength, tendons can be sensitive to changes in load. Injuries often occur when activity levels increase too quickly or when the tendon is exposed to repeated stress without adequate recovery.

This might look like:

• Increasing running distance too quickly

• Returning to sport after time off

• Starting a new gym program

• Repetitive work tasks without conditioning

How Tendon Injuries Typically Present

Most tendon injuries share some common features:

• Localised, pinpoint pain directly over the tendon

• A “warm-up effect” where pain eases during activity

• Symptoms that worsen after activity or the following day

• Reduced strength or tolerance to load

The good news is that tendons respond well to the right type of loading.

At Kinima Physio, we focus on:

• Identifying contributing factors

• Modifying load without complete rest

• Using objective testing to assess strength and capacity

• Building progressive, evidence-based rehab programs

• Guiding a structured return to activity

Complete rest is rarely the answer. Instead, we aim to find the “sweet spot” of loading that promotes adaptation without excessive flare-ups.

Elbow Tendinopathy (Medial and Lateral)

Elbow tendon injuries commonly affect either the wrist extensor tendon (lateral elbow) or wrist flexor tendon (medial elbow).

These muscles play an important role in gripping, lifting, and controlling wrist and forearm movements.

Common in:

• Trade workers

• Racquet sports

• Throwing athletes

• Gym training

• Desk-based work

Common signs include:

• Localised pain on the inner or outer elbow

• Pain with gripping, lifting, or carrying

• Symptoms that worsen after activity

• Reduced strength with functional tasks

Gluteal Tendinopathy

Gluteal tendinopathy affects the tendons on the outside of the hip and is often mistaken for “hip bursitis”.

These muscles help stabilise the pelvis and control movement during walking, running, and single-leg tasks.

Common in:

• Peri and post menopausal women

• Recreational runners

• Long distance walkers

Common signs include:

• Pain on the outside of the hip

• Pain with walking, stairs, or lying on the affected side

• Discomfort with crossing legs

• Reduced strength during single-leg tasks

Proximal Hamstring Tendinopathy

The proximal hamstring tendon attaches at the ischial tuberosity, often referred to as the “sit bone”.

This condition affects the tendon at the top of the hamstring, near the sit bone.

It plays an important role in controlling movement during running and stabilising the pelvis.

Common in:

• Runners and track athletes

• Field sport athletes

• Individuals who sit for prolonged periods

Common signs include:

• Pain in the lower buttock region

• Pain with running, sprinting, or prolonged sitting

• Symptoms that ease with movement but worsen later

• Reduced hamstring strength

Patellar Tendinopathy (Jumper’s Knee)

Patellar tendinopathy affects the tendon below the kneecap and is common in jumping and running sports.

It plays a key role in force transfer during movement and impact absorption.

Common in:

• Court and field sport athletes

• Track and field athletes

Common signs include:

• Pain just below the kneecap

• Pain with jumping, landing, or stairs

• Warm-up effect during activity

• Reduced strength and power

Achilles Tendinopathy (Mid-Portion and Insertional)

The Achilles tendon connects the calf muscles to the heel and is essential for walking, running, and jumping.

There are two main types:

• Insertional (at the heel bone)

• Mid-portion (slightly above the heel)

Each requires slightly different management.

Common in:

• Runners

• Court and field sport athletes

• Gym-based training

• Trade workers

Common signs include:

• Localised pain in the tendon or heel

• Pain with walking, running, or stairs

• Stiffness, especially in the morning

• Reduced calf strength and endurance

What Should You Do If You Have Tendon Pain?

If you’re dealing with tendon pain, the key is not to completely rest, but to manage your load and gradually rebuild strength.

A simple starting point includes:

• Reducing activities that significantly flare your pain

• Avoiding sudden spikes in training or load

• Introducing controlled strength exercises

• Monitoring how symptoms respond over 24 hours

• Staying active where possible without worsening symptoms

In some cases, physiotherapy may also include adjunct treatments such as manual therapy, dry needling, or shockwave therapy to help manage symptoms and support your rehabilitation alongside an exercise-based approach.

If symptoms are persisting, limiting your activity, or not improving over time, it’s worth getting assessed.

A physiotherapist can help identify the contributing factors, guide your loading, and build a structured plan to support recovery and return to activity.

Final Thoughts

Tendon injuries are common, but with the right approach, they are highly manageable.

The key is:

• Understanding your load

• Building strength progressively

• Addressing symptoms early

With structured rehabilitation, most people can stay active while recovering and return to full performance over time.

Written by Janelle Juse
Physiotherapist, Kinima Physio

Janelle has a strong interest in exercise-based rehabilitation and helping individuals manage tendon-related injuries. She takes a structured, progressive approach to loading, helping clients build confidence and return to meaningful activity.

Janelle consults from our Kinima Physio Gwelup clinic, working with clients from Gwelup, Stirling, Innaloo, Karrinyup and surrounding northern suburbs.