Why Your Tendon Pain Keeps Coming Back And What Actually Works to Fix It

If you’ve been dealing with tendon pain—whether it’s in your Achilles, patellar tendon, elbow, or shoulder—you’re not alone. Tendinopathy (sometimes called tendinitis or tendinosis) is one of the most stubborn injuries out there. You rest, it feels better, you go back to activity… and bam—pain again.

So, what gives?

At Pain & Performance Coach, we take a different approach to treating tendinopathy. We don’t just chase pain. We target the root cause using proven, science-backed strategies.

What Is Tendinopathy (Really)?

Tendinopathy refers to pain and dysfunction in a tendon—not due to inflammation, but due to overload and failed healing. It often happens when the tendon can’t keep up with the demands placed on it—whether from sports, work, or everyday movement.

Common sites include:

• 🏃 Achilles tendon (heel)

• 🏀 Patellar tendon (knee)

• 🎾 Tennis/golfer’s elbow

• 🏋️ Rotator cuff (shoulder)

• 🧑‍💻 Proximal hamstring (deep bottom of the glutes, a literal pain in the butt)

[shown above is an image inspired by a comparable image from the article “Tendinopathy” by Millar et al. 2021]

The good news about all of this? Modern rehab science has come a long way, and we now know exactly what works.

Old Treatments That Don’t Cut It Anymore

Here’s what the research says not to waste your time on:

• ❌ Rest alone

• ❌ Stretching-only programs

• ❌ Cortisone injections (they may give short-term relief, but can weaken tendons long-term)

• ❌ Passive modalities (like ultrasound or TENS)

According to the 2023 UK Defence Rehabilitation Consensus, these approaches fail to build tissue tolerance and return long-term function.

What Actually Works? Progressive Loading

The best results come from progressive, structured loading of the tendon. This means we gradually expose your tendon to higher demands in a smart, planned way.

At our clinic, this includes:

• Isometric loading for pain relief early on

• Heavy slow resistance (HSR) training for long-term tendon remodeling

• Plyometrics and sports-specific drills for return to play

We have a similar broad approach to the UK consensus model: start by building capacity, then restoring power, and end with an emphasis on return to sport.

Load Management: The Secret Sauce

Tendons don’t like too much too fast—or too little for too long. We help you strike the perfect balance:

• Weekly load planning

• Activity modification (not just “rest”)

• Return-to-sport testing

• Ongoing tracking via force output and performance metrics

We don’t guess. We test and retest to guide every phase of your recovery.

Why Recurrence Is So Common (And How We Stop It)

Most people relapse because they never truly restore their tendon’s full strength and function. You feel better… but your tendon isn’t ready. That’s why we include:

• Sport-specific jumping, running, or throwing drills

• Change of direction and landing technique work

• Strength symmetry testing and performance benchmarks

Our tendinopathy rehab isn’t just about pain relief—it’s about full return to performance.

Local Tendon Rehab Experts in Hillsboro & Beaverton

At Pain & Performance Coach LLC, we specialize in high-performance rehab for athletes and active adults recovering from chronic tendon injuries. Whether you’re struggling with:

• Achilles tendinopathy

• Jumper’s knee

• Tennis elbow

• Shoulder tendinopathy
  …we’ve got a game plan that’s built on results, not guesswork.

We’re located in Hillsboro and proudly serve the Beaverton, Aloha, Forest Grove, and North Plains communities.

Ready to Get Back to Doing What You Love?

Book an evaluation today and experience the difference of evidence-based, performance-focused tendon rehab.