Why Tendons Are Trouble, Whether You're Active or Not

We recently launched a new Tendon Clinic, a specialist service for tendon injuries and pain. Though we treat people for a wide variety of issues, tendon problems are so common that we realised they need extra attention.

So what is it about tendons that makes them such a regular appearance at WLP?

To understand why tendons cause so many issues, first you need to understand how they work.

Tendons are tissues within the body that attach a muscle to a bone, whereas ligaments are the tissues that attach a bone to another bone. The mechanics are simply explained: force generated by a muscle contraction is transmitted through the tendon, which then pulls on the bone and moves the joint.  Without tendons, you can’t move.

Though tendons don’t generate force, some larger tendons have the ability to store and release a huge amount of elastic energy. For example, the Achilles tendon (the long thin tendon at the back of your leg) is responsible for a significant portion of the energy used and recycled while walking and running. It functions much like a spring, propelling your body forward.

The reason we have to treat tendons so regularly is that they are at risk of injury and pain whether you’re highly active or chronically sedentary.

  • Tendon problems if you’re active
    Active people typically put huge stresses through their tendons. If these tendons aren’t given enough time and recovery to adapt to this stress, then tendon pain can occur. Tendon pain is very common in footballers during preseason as they are training incredibly hard. This is due to what we call overload.
  • Tendon problems if you’re sedentary
    A tendon requires a certain amount of stress placed on it on a daily basis to remain healthy, otherwise the tendon may weaken, which is called underload. For chronically sedentary people, even simple movements such as standing up or climbing stairs can cause pain in their tendons. General exercise doesn’t just benefit your heart and lungs but also for your tendons!
  • Tendon problems if you’re overweight
    Underload can be further compounded by being overweight, as the tendons, in addition to being weak, need to carry more weight than they can bear. High cholesterol – often associated with being overweight – can cause fatty lipids to be deposited within a tendon, further compromising the structure. Statin medication, commonly taken in people with high cholesterol and diabetes, has also been associated with tendon disorders.

Whether your pain is caused by being too active or not active enough, tendon problems need to be treated carefully as they take longer to heal than muscles as blood supply to the tissue is poor in comparison. While sore muscles can recover overnight, painful tendons may take weeks or months to return to normal.

There’s too much to say about tendons to fit in one blog post, so join me again next month to find out how we treat tendon problems and what you can do to reduce your risk of suffering one. Until then, if you have any questions or concerns about your tendon health, feel free to get in touch at info@westlondonphysio.co.uk

david wynne physiotherapist knightsbridge


David Wynne BSc (Physio) MSc (Sports and Exercise Medicine) MCSP MHCP

Musculoskeletal and Sports Physiotherapist, Research Lead at West London Physiotherapy

For any other questions regarding this topic please do not hesitate to contact West London Physio on 0207 937 1628 or email David at david@westlondonphysio.co.uk