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Staying active with tendon pain: how much pain is acceptable

Sprague, A. et al. Distinguishing Quadriceps Tendinopathy and Patellar Tendinopathy: Semantics or Significant? JOSPT, 2019, 49(9).

A very common question physical therapists are asked is, "how much pain is safe to have during exercise?" In general, it is acceptable to continue being active with some amount of pain without making the problem worse. It is helpful to have some guidelines to know how much pain is okay, and how adjust your activity level should your pain exceed recommended levels. The above figure has been used in many resources related to tendon problems - think "achilles tendinitis," or "jumper's knee" - to help people monitor their response to activity.

What do you do if your tendon pain exceeds the four guidelines above? Does it mean you have to stop all activity? The answer is likely "no," but modifying what you're doing is important to ensure that you don't make the problem worse. Whether you run, play basketball, or lift weights, adjust your activity to decrease the stress on your tendon. Run a shorter distance, or decrease the amount of hills you run; play basketball for 30 minutes instead of 45; decrease the amount of weight you're lifting, or don't move as far into your lifts.

These rules often apply to many other types of problems and injuries, such as kneecap pain, shoulder pain, and low back pain. As always, contact Jon or Ryan at Village Physical Therapy if you have questions about this post, or anything else physical therapy related!

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