Cases of tendonitis can vary dramatically in severity, ranging from mild irritation to debilitating pain. Though physical therapy can technically help any case of tendonitis, there are some cases where it may be more of a necessity than others.
Someone should seek physical therapy for tendonitis when:
- Pain persists for more than a few days despite rest or self-care
- Swelling, stiffness, or discomfort limits daily activities
- Symptoms worsen over time instead of improving
- Weakness or reduced range of motion develops in the affected area
- Home remedies like ice, stretching, or over-the-counter medication don’t provide relief
Seeking physical therapy early can help prevent chronic issues or further damage. In this article, we’ll discuss how to recover with or without physical therapy, and provide some insight into whether or not you should seek professional help for your case.
Physical therapy isn’t always necessary for tendonitis
Most of us have experienced some type of tendon injury in our lives: the inflammation of a tendon, typically accompanied by pain and tenderness, resulting from overuse of a joint that wasn’t prepared to handle the particular workload.
As such, most of us are familiar with the fact that tendonitis will often resolve on its own. The key is to catch it early enough.
If you notice that you’ve got:
- Mild tenderness or swelling around a joint
- A dull, aching pain around that same joint
- Pain during movement (especially after a period of rest)
… then you’ve probably got some mild tendonitis. If, during this period, you discontinue the activity causing the pain, and apply basic recovery techniques like ice and elevation, you can expect that most cases of tendonitis will resolve on their own within a couple of weeks.
If you’re noticing more extreme symptoms (or if your symptoms have persisted beyond 2-4 weeks), you may want to get a physical therapist involved.
When to contact a physical therapist about tendonitis
More severe cases of tendonitis may require intervention from a skilled physical therapist. There are a handful of signs we look for when recommending professional intervention versus self-care:
- If pain has persisted for more than a week or two
- If symptoms continue to worsen, despite your self-care efforts
- If you notice weakness or a reduced range of motion
- If the pain is severe, affecting your sleep, or causing lifestyle problems
Chief among these factors would be the first factor mentioned above: if the pain is persistent for more than a week or two. This is because tendonitis can become a long-term issue if the injury becomes chronic:
Chronic vs acute tendonitis
We refer to tendonitis as chronic tendonitis if the issue persists for longer than about six weeks. At this point, it is most prudent to work with a professional. This is also why we recommend you get in touch with a professional if the pain persists longer than a couple of weeks:
- Chronic tendonitis is tougher to treat, and requires lifestyle modifications that can last for months (or even a year in some cases), as opposed to weeks
- During chronic cases, tendon degeneration is common, wherein the tendon continues to break down and becomes unable to heal on its own
- This can lead to a cycle of reinjury that can last years
For this reason, we always recommend you work with a physical therapist if the injury isn’t resolving on its own.
How physical therapy can help with tendonitis
Physical therapy can effectively help tendonitis by reducing pain, improving mobility, and preventing recurrence through targeted exercises. Studies have shown significant pain relief and functional improvements.
Physical therapy is one of the best non-invasive ways to tackle tendonitis. If you’re finding yourself wanting to get back to doing what you love without jumping into surgery or medications, physical therapy treatment plans can greatly improve your condition:
Reducing pain
Pain management is usually the first thing you want to deal with when tendonitis hits. Physical therapists can help relieve pain by using ice or heat to reduce inflammation.
We often use TENS (Transcutaneous Electrical Nerve Stimulation) and for many, this can be a replacement for pain relievers and other medications with side effects.
Regaining and improving upon lost mobility
Tendonitis can make simple things—like reaching for a cup or walking up stairs—feel like a chore. Physical therapy is all about helping you move better again.
Gentle stretches and movements loosen up stiff tendons and help get your range of motion back on track. We also use manual therapy techniques like soft tissue mobilization to encourage the healing process and the restoration of proper ranges of motion.
Rebuilding and improving upon lost strength
Strengthening exercises are a big part of recovery, focusing on exercises that not only help the tendon heal but also take stress off it by strengthening the muscles around it.
Things like eccentric exercises are great for tendonitis—they involve lengthening the muscle as it contracts, which helps rebuild damaged tendon fibers and boost collagen production.
Fixing faulty movement patterns
Sometimes, tendonitis happens because of the way you’re moving—or not moving. Maybe your posture’s off, or you’re doing something repetitive in a way that’s stressing out your tendon.
A physical therapist will take a close look at how you move and suggest tweaks, like adjusting your desk setup or changing how you lift weights. We can also use techniques like kinesio taping to help support the area and encourage changes to your movement patterns. Making small changes over time can make a huge difference in how you feel long term.
Reducing reinjury risk
Physical therapy isn’t just about fixing what’s hurting right now—it’s about making sure whatever is bothering you can become manageable. All physical therapy plans come with a home exercise program to keep up your strength and flexibility.
Exercises like heel raises for Achilles tendonitis, wrist stretches for tennis elbow, or shoulder exercises for rotator cuff issues can be a good place to start. Just remember to communicate with your physical therapist or doctor before trying anything new at home—to make sure it’s safe for you.
Can physical therapy help a torn tendon?
In cases of a torn tendon or a tendon rupture, physical therapy should definitely be part of the plan, when the time is right.
Tendon tears range in severity from partial tears to complete tears. In the case of a complete tear, surgery is required with physical therapy afterward. However, in cases of partial tears, physical therapy is a treatment option with a high success rate.
If this is the case, be sure to discuss your treatment options with your provider, to determine the best path forward.
Will physical therapy make tendonitis worse?
In general, physical therapy will make tendonitis better, not worse. However, if your injury isn’t properly diagnosed (such as in the case of a torn tendon), then physical therapy could be “too much, too soon,” causing damage. Note that we are not referring to the common physical therapy side effect wherein patients sometimes report that they feel worse before they feel better.
However, a licensed physical therapist is used to seeing patients for tendonitis, and should have the skills to determine whether or not their services are likely to be helpful. If you’re concerned about this, make sure to discuss it with your therapist to avoid any misunderstandings.
Best practices for tendonitis self-care
If you’ve decided to attempt to rehabilitate your tendonitis on your own (based on the information above), there are some basic best practices we give our patients to follow:
- First, discontinue the activity that caused the pain. This can be challenging if your injury is resulting from an activity you love, like running, sports, playing and instrument, etc. However, it is not recommended to “train through the pain” when it comes to tendonitis. Unless you wish to have a nasty chronic injury requiring months of lay-off, commit to resting the area until the injury resolves.
- Take over-the-counter anti-inflammatory pain relievers like Ibuprofen, if needed. Be sure to follow the instructions on the bottle.
- Ice the area every few hours for 15-20 minutes.
- Gently stretch the area, once the pain eases.
- After you’ve experienced no pain for at least 48-72 hours, reintroduce light activity involving the affected joint. Be sure to discontinue activity if the pain returns, rinse and repeat.
As we’ve noted many times in this article, contact a physical therapist for an evaluation if you try the steps above and seem to be making no progress.
Common questions
