Tendinopathy — Physiotherapy in London
Tendinopathy is an overload injury of a tendon — most often the Achilles, patellar, gluteal, or rotator cuff. At our Tottenham Court Road and London clinics we diagnose the overload behind it and rebuild capacity with progressive loading, the treatment with the strongest evidence base. Self-referral; no GP referral needed.
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What you're seeing
The concern
Why it happens
What drives it
- A rapid spike in training, running mileage, or gym load that outpaces the tendon's ability to adapt
- Repetitive or sustained loading of one tendon (Achilles, patellar, gluteal, rotator cuff) without adequate recovery between sessions
- Strength and conditioning deficits in the surrounding muscle group, so the tendon absorbs load it is not prepared for
- Returning to full training too soon after a previous injury, before the tendon has rebuilt its capacity
- A sudden change in footwear, running surface, training pattern, or technique without an adaptation period
- Reduced tendon tolerance associated with age, certain medications, or metabolic and hormonal health factors
Treatment approach
How David treats it
Sports Physiotherapy
Price on enquirySports-focused assessment identifies the tendon involved and the overload behind it, then delivers a progressive-loading programme with objective return-to-sport criteria — the best-evidenced treatment for Achilles, patellar, gluteal, and rotator-cuff tendinopathy in active people.
See treatment detail →Physiotherapy
Price on enquiryHands-on physiotherapy combines diagnosis, education, manual therapy, and a structured loading plan to rebuild tendon capacity, with realistic milestones for recreational and working patients managing a painful, overloaded tendon.
See treatment detail →FAQ
Common
questions
What is the difference between tendinitis and tendinopathy?
Tendinopathy is the accurate term; tendinitis is largely outdated. "Tendinitis" implies inflammation, but research shows most long-standing tendon problems are not primarily inflammatory — they are overload-driven changes in tendon structure. This matters for treatment: rest alone rarely works, whereas progressive loading rebuilds the tendon's capacity over time.
What is the best treatment for tendinopathy?
Progressive loading is the primary, best-evidenced treatment, supported by NHS guidance and the British Journal of Sports Medicine consensus. A structured, graded exercise programme gradually rebuilds the tendon's tolerance to load. Manual therapy and acupuncture can help manage pain alongside loading, but exercise is the core of recovery, not an optional extra.
Should I rest a tendinopathy completely?
Usually not. Complete rest may ease pain briefly, but it lets the tendon lose capacity, so symptoms return when you resume activity. The evidence supports relative rest — temporarily reducing aggravating load while progressively rebuilding tolerance through structured exercise. Your physiotherapist guides the right amount of load for your stage of recovery.
How long does tendinopathy take to recover?
Tendon tissue adapts gradually, so recovery is rarely quick — typically three months or more of consistent, progressive loading, sometimes longer for the Achilles or gluteal tendons. We set realistic milestones at your first appointment and reassess regularly. See a GP urgently if you suspect a sudden tendon rupture with severe pain or weakness.
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Kaizen Physiotherapy & Performance • 111 Charing Cross Road, Tottenham Court Road, London WC2H 0DT
BookAppointments typically available within 1–2 weeks