While tendons are very robust structures, they do go wrong occasionally. When they do, they cause pain and difficulty moving.

Tendons connect your muscles to bone. All muscles have tendons, usually one tendon at each end of the muscle.

Tendons are made up of protein, arranged as densely packed fibres somewhat like the cables used in suspension bridges.

You may have heard the word tendinitis used when someone has a tendon problem. Tendinitis literally means inflammation of a tendon.

Medical research shows us that tendon problems are complex and involve more than just inflammation. For this reason, the diagnosis of tendinitis is no longer recommended, being replaced by tendinopathy.

Tendinopathy can be translated as tendon disease, and refers to a wide range of changes that affect a tendon when it has been damaged.

But why do tendons get damaged?

There is a myth that tendons, which are put under strain when a muscle contracts, get damaged when exposed to too much strain.

READ MORE:Exercise helps inflammatory joint pain

But for most people, it’s truer to say that the reverse is true. Tendons get damaged when they are not exposed to enough strain.

The pull a muscle exerts on a tendon is limited by that muscle’s strength. As it takes time for a muscle to increase in strength, the tendon attached to that muscle has ample time to adapt to the increasing force applied to it.

However, if tendons are not placed under regular load they start to degenerate. The material the tendon is made up of loses its toughness, and then even very small forces can cause problems.

This explains why the overwhelming majority of tendon issues are degenerative, taking a long time to build. But this also shows us the solution to most tendon problems. And, as with most injuries, that solution is adequate use and training.