Understanding and Treating Tendonitis with Physical Therapy

Understanding and Treating Tendonitis with Physical Therapy

Introduction

Tendonitis (or tendinitis) is the inflammation of a tendon—the thick, fibrous tissue that connects muscles to bones. It is most often caused by repetitive stress, overuse, or improper movement patterns that lead to tiny tears and irritation within the tendon.

Although tendonitis can occur anywhere in the body, it is most common in the:

• Elbows

• Knees

• Shoulders

• Hips

• Achilles tendon

• Base of the thumb

Because it often occurs from repetitive motions, tendonitis is commonly known by activity-based names such as Tennis Elbow, Golfer’s Elbow, Swimmer’s Shoulder, Pitcher’s Shoulder, Jumper’s Knee, or Achilles Tendinitis.

If you're experiencing pain or tenderness just outside a joint, especially during movement, tendonitis may be the cause. Without proper treatment, tendonitis can worsen and increase the risk of a tendon rupture.

How Physical Therapy Treats Tendonitis

Physical therapy is one of the most effective treatments for tendonitis. It reduces inflammation, restores movement, strengthens surrounding muscles, and helps prevent the condition from returning. Below are the most common PT approaches used to treat tendonitis.

Pain Management Exercises

These exercises are designed to reduce inflammation, relax tight tissues, and reduce tension on the injured tendon.

Examples include:

• Calf Wall Stretch / Eccentric Heel Drops – for Achilles tendonitis

• Wrist Curls / Wrist Extensor Stretch – for tennis elbow

• Contrast therapy (hot/cold), soft tissue massage, rest intervals – for general pain relief

Manual Therapy

Hands-on techniques help improve mobility, decrease tightness, and promote healing.

Common methods include:

• Assisted stretching

• Cross-friction massage

• Myofascial release

• Trigger point release

• Joint mobilization

• Passive range of motion

These techniques help reduce inflammation, improve circulation, and restore functional movement.

Stretching and Strengthening Exercises

These exercises improve flexibility, reduce tendon tightness, and rebuild strength to prevent further injury.

Examples include:

• Calf stretch – for Achilles tendonitis

• Wrist extensor stretch – for tennis elbow

• Cross-body shoulder stretch – for rotator cuff tendonitis

• Hamstring stretch – for lower limb tendonitis

Range of Motion (ROM) Exercises

ROM exercises improve mobility, reduce stiffness, and help tendons glide smoothly again.

Examples include:

• Ankle pumps – Achilles tendonitis

• Wrist circles – Golfer’s elbow

• Pendulum swings – Rotator cuff tendonitis

• Heel slides – Patellar tendonitis

• Wall walks – Rotator cuff tendonitis

• Supination/pronation – Elbow tendonitis

• Toe spreads – Plantar fasciitis

Functional Training

Functional exercises mimic everyday movements and strengthen tendons during real-world activity.

Examples include:

• Step-ups – Patellar tendonitis

• Single-leg balance – Patellar tendonitis

• Farmer’s carry – Shoulder or elbow tendonitis

• Lateral band walks – Knee tendonitis

• Push-offs – Achilles tendonitis

Gradual Return to Activity

This phase bridges the gap between rehab and full activity by preparing the tendon for increased stress safely.

Examples include:

• Walking progression – Lower limb tendonitis

• Modified push-ups – Shoulder tendonitis

• Light hopping or mini jumps – Achilles or patellar tendonitis

• Step-back lunges – Achilles or patellar tendonitis

• Cycling – Lower limb tendonitis

Takeaway

Physical therapy is the key to treating tendonitis—from reducing pain and inflammation to restoring mobility and safely reintroducing activity. A skilled physical therapist will help identify contributing factors, suggest activity modifications, and guide you through a personalized rehabilitation plan.

With the right treatment, tendonitis is highly manageable—and full recovery is achievable.

At TLC Physical Therapy, our team provides personalized treatment plans to help you reduce tendon pain, restore mobility, and rebuild strength safely and effectively. Whether your tendonitis developed from overuse, repetitive motion, or an injury, we guide you through every stage of recovery with expert care. Your healing matters to us—let’s get you back to moving comfortably and confidently.