Can You Train Through Tendon Pain?

Why Complete Rest Often Backfires

The traditional instinct when a tendon becomes painful is to stop loading it entirely until the pain resolves. For tendinopathy specifically, this approach is often counterproductive — tendons generally respond poorly to complete unloading, and prolonged rest can allow the tendon's capacity to deteriorate further, setting up a worse relapse once activity eventually resumes.

A Structured Alternative: The Pain-Monitoring Model

A randomised controlled trial in patients with Achilles tendinopathy found that continuing sports activity using a structured pain-monitoring model — permitting activity as long as pain stayed below a defined, acceptable threshold on a simple 0–10 scale, and did not worsen significantly the following morning — produced comparable or better outcomes than a more conservative, activity-restricting approach (Silbernagel et al., 2007).

How This Is Applied in Practice

In practice, this typically means training can continue provided pain remains mild (often capped around 3–4 out of 10), does not increase during the activity itself, and returns to baseline levels within 24 hours — a framework that allows the tendon to continue receiving the loading it needs to adapt, while still respecting its current capacity.