Tendons are strong tissues made of collagen proteins that connect muscle to bone. Tendons transmit forces from muscle belly to the joint and the pull of these tendons when muscles contract is how we create movement. Tendon pain usually occurs from repetitive overloading, which causes breakdown of the collagen tissues leading to pain and limitation of function. The medical term for dysfunction in a tendon is tendinopathy.
Any tendon in the body can develop pain. There are multiple sites in the lower limb where tendinopathy can occur. These include the gluteus medius, psoas (hip flexor), and adductor tendons on the hip, the hamstring and patella tendon at the knee and the achilles, peroneal tendon, tibialis posterior tendons in the foot and ankle.
Physiotherapy is the first line treatment in the management of tendinopathy and centres around education on load management and addressing modifiable risk factors to reduce pain. In addition to this a graded strengthening program over 12 + weeks has been shown to be effective in improving pain and function in multiple different tendinopathies including achilles, patella and gluteus medius (see here).
