Tendinopathy is a failed healing response in an overloaded or underloaded tendon. It doesn’t respond well to rest, anti-inflammatories or cortisone alone. At Thrive, we use evidence-based progressive loading protocols to rebuild tendon capacity and get you back to what you love.
Tendons connect muscle to bone. When they are exposed to load beyond their current capacity — or severely underloaded — they can develop a failed healing response called tendinopathy. Common presentations include Achilles pain in runners, patellar pain in jumping athletes, gluteal pain at the hip and rotator cuff pain in overhead workers and athletes. The defining principle of tendinopathy treatment is progressive loading: the tendon must be loaded to heal.
Mid-portion or insertional Achilles pain, common in runners and active adults over 35. Treated with an eccentric or heavy slow resistance loading program.
‘Jumper’s knee’ — pain at the inferior pole of the patella during jumping and loading activities. Isometric loading first, then heavy slow resistance.
Lateral hip pain at the greater trochanter, especially with sitting and stair climbing. Progressive hip abductor loading is the evidence-based approach.
Supraspinatus or infraspinatus degeneration causing shoulder pain with overhead activity. Targeted rotator cuff and scapular loading program required.
Tendinopathy is actually a degenerative condition, not a purely inflammatory one — the tissue shows failed healing, not active inflammation. Anti-inflammatories provide minimal benefit beyond the acute phase, and rest without progressive reloading reliably leads to recurrence. The tendons needs to be loaded — intelligently and progressively — to drive the healing response.
We assess your tendon’s current capacity, identify the training error or load spike that caused the problem, and establish a baseline for your loading program.
Isometric loading for immediate pain management, progressing to heavy slow resistance, functional movements and finally sport-specific loading — based on symptom response.
Running, jumping, overhead throwing — we use validated criteria (not just pain absence) to determine when you’re ready to return to full activity.
Tendons adapt to load — rest causes them to lose capacity (become more vulnerable to loading). When you return to activity after a rest period, the tendon is often weaker and more reactive than before. Progressive loading maintains and builds tendon capacity.
Moderate Achilles or patellar tendinopathy typically improves meaningfully in 6–12 weeks, with full return to sport at 3–6 months. Gluteal tendinopathy can take slightly longer. Chronic tendinopathy (>3 months) responds more slowly but still improves significantly with the right program.
This is a very common pattern. Cortisone reduces tendon pain short-term but can weaken tendon tissue and doesn’t address the load deficit. The solution is a proper progressive loading program — which we can start at an appropriate level relative to where your tendon is now.
Sometimes — depending on severity. We use the VISA-A score and a pain-monitoring model to determine whether you can run through symptoms or need a short load reduction period before building back. The goal is always to keep you as active as possible.
Book an assessment and we’ll start the loading program that your tendon actually needs.
Parramatta, NSW · In-clinic & Home Visits · Private, Medicare, WorkCover, NDIS
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