Some Pain Is Part of Getting Better

One of the most common things I hear from people dealing with tendinopathy — whether it's Achilles pain, golfer's elbow, or patellar tendon issues — is some version of this:

"I stopped as soon as it started hurting because I didn't want to make it worse."

That instinct makes complete sense. Pain usually means stop. But with tendons, the story is more complicated — and understanding it can make the difference between a long, frustrating recovery and one that actually moves forward.

Why Tendons Are Different

Tendons don't heal well with rest. That's the inconvenient truth that a lot of people — and practitioners — haven't fully reckoned with. Unlike a bruise or a muscle tear, a tendon that's been offloaded tends to get weaker, more disorganized, and more sensitive over time. Rest doesn't reset it. It just deprives it of the signal it needs to rebuild.

That signal is load. Mechanical stress is literally the language tendons speak. Without it, the tissue doesn't know to adapt. With the right amount of it, the tendon responds — laying down new collagen, stiffening up, and gradually becoming more capable.

Here's the catch: that process often comes with some pain. Not because something is going wrong, but because the tendon is being asked to do something it currently struggles with. It's telling you it's working hard. That's different from telling you it's being damaged.

Pain as Information, Not Alarm

Think of it this way. When you start a new strength program after months off, your muscles are sore for a few days. That soreness isn't a sign you hurt yourself — it's evidence that you challenged your tissue and it's now adapting. Tendons work on a similar principle, just with a longer timeline and a narrower window of tolerance.

The question isn't "did it hurt?" The question is: what kind of hurt, how much, and what happened afterward?

For most people with tendinopathy, a pain level of 3–4 out of 10 during activity is not just acceptable — it's expected and often productive. It means load is getting through. It means the tendon is responding. That's where adaptation happens.

So — Can You Play? Can You Run?

This is the question I hear constantly. "My elbow hurts when I golf. Should I stop playing?" Or: "My Achilles flares up every run. Is that okay?"

The honest answer is: it depends on what happens next. Here's the rule of thumb I use with my clients:

• Pain during or shortly after activity that settles back to your baseline within 24 hours? Generally okay to continue. That's within the window. Your tendon handled the load — it's just telling you it noticed.
• Pain that's significantly worse the next morning, or that keeps escalating over days? That's a sign the load exceeded what the tissue could absorb right now. Not catastrophic — but a signal to dial back, not stop entirely.

The goal is to find the edge and work just inside it — not avoid the edge completely.

Reading Your Tendon Pain: A Quick Guide

Here's how I frame it for the people I work with. Think of it as a traffic light:

The 24-Hour Rule

The most practical tool I give people is this: check in the next morning. How does the tendon feel when you first get up? Compare it to how it felt before the activity.

• If it's about the same, or just a touch more sensitive — you're in range. Carry on.
• If it's meaningfully worse the next day, you went over. Not a disaster — just useful information. Scale back the volume or intensity of your next session, and monitor the response again.

Over time, this feedback loop is how you build capacity. You're not just rehabbing a tendon. You're teaching yourself what it can handle, and gradually expanding that range.

The Fear Makes It Worse

There's one more piece worth naming: the fear of pain itself can amplify how much pain you feel. This isn't "it's all in your head." It's neuroscience. The nervous system is always making predictions about threat, and if every twinge sends a message of danger, the system gets more protective — not less.

When you understand that some pain is expected, that it doesn't mean damage, and that you have a framework for reading what it's telling you — that understanding actually changes the experience. The pain doesn't vanish, but it loses some of its urgency. And urgency is what drives avoidance, which is what stalls recovery.

Pain should always be respected. But it shouldn't always be feared. With tendons, some of it is simply the sound of work being done.

The Bottom Line

Tendinopathy recovery isn't about finding a pain-free path through. It's about finding a load-tolerant one. Some discomfort during this process is normal, expected, and often a sign that the right things are happening.

Keep playing golf. Keep running. Keep doing the things that matter to you — just do them with a framework, not blind hope. Monitor the 24-hour response. Stay in the yellow zone or below. And if you're unsure what you're working with, get it assessed by someone who can help you build a progressive loading plan that fits your life.

The tendon wants to get better. Give it the chance.

If you want to understand what productive loading actually looks like in practice, my complete guide to heel raises for Achilles tendinopathy walks through the approach step by step. And if you'd like help building a plan around your specific situation, you can book a 1-on-1 session with me directly.