Tendon Toughening – (For Achilles / Patella / Gluteal / Golfers and Tennis Elbow)

We have all heard of Achilles tendonitis but what about gluteal or patella tendonitis? Maybe you have heard of golfers or tennis elbow (also tendon problems!). Tendon problems are super common and can be really painful. They are often worse with walking, running, lifting and carrying.

Pain and inflammation located around the tendon occurs as a result of overstrain or overload.

What Causes It

Multi-factorial but often due to changes in loading behaviour (running/jumping/pushing/pulling/stretching, training changes – distance/surfaces/intensity/weight gain).


Normally takes 3-6 months to resolve but can last many years if not managed correctly.

Your Goal / Targets

The severity of pain and injury, the length of time you have had your problem for and where you want to get to (what level of function or activity) will have a bearing on what treatment you require and how long you may need to see us for.


Treatment is normally carried out over a 3-4 month period and requires approximately 10-12 sessions.

Review / Reassessment

At the end of your treatment we will review your progress and plan the next steps. This may be discharge with advice and an ongoing maintenance home exercise programme or it could be further sessions to progress you to more challenging exercises, to prepare you for work or a specific sport.

Patient Undergoing Treatment

Treatment Programme

  • Off load (advice/education)
  • Manage pain – Medication / Ice / Acupuncture
  • Shockwave Therapy (if appropriate)
  • Support Taping / Orthoses (insoles) / footwear choice
  • Analysis of biomechanics – video gait analysis
  • Progressive exercise programme to include:
    Stretching of tight structures (as identified on your assessment)
    Focused strengthening and retraining of muscles that help to support the leg and foot
    Proprioceptive coordination drills to improve leg and foot co-ordination
  • Retraining of movement patterns / sport specific input e.g: running coaching re-education

Next Steps

Want to know more? Then please download our Information guide – Achillies Tendinopathy for Runners (even if you don’t run it will be useful).

Important Information

Rehabilitation is not a quick fix and can be longer due to age, length of symptoms, and the extent of degeneration and weakness. It is very important that you attend your treatment sessions as suggested by your therapist and follow through with your re-assessment. The recommendations in this action plan are based on your individual condition and examination results.

Next Steps: Use one of our 4 options below to get started...

What Our Patients Say

Lindsey 34 Hutton, Essex “I was in 10 out of 10 back pain... now after my treatment I am feeling much better and am back in the gym using the cross trainer and stair master again”
Jane 38 Brentwood, Essex “I was suffering from debilitating headaches 3 times a week... the hands on treatment was really good even after the first session I felt amazing! Now I feel fantastic!”
Mark 41 Langdon Hills, Essex “You isolated the problem to damage in my lower disc... It’s now hugely better and I am back to football”


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