Tendon, muscle and soft-tissue pain

Tendon, muscle, and soft-tissue injuries are common causes of pain affecting daily activity, work, and exercise. They often develop gradually due to overuse, but can also occur suddenly following strain or injury. Although recovery can be slow, most people improve with the right rehabilitation approach.

This page explains how tendon and muscle pain presents, common causes, how a GP assesses these injuries, and when further review is needed.

These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help with ongoing joint concerns, please book a GP appointment.

Book a GP appointment

How soft-tissue pain commonly presents

Tendon and muscle related pain may present as:

Localised pain that worsens with movement or load
Stiffness, particularly first thing in the morning or after rest
Pain during gripping, lifting, walking, running, or pushing off
Tenderness over a specific area or attachment point
Muscle tightness or cramping
Reduced strength or endurance in the affected area
Symptoms that flare after activity rather than during it

Muscle strains tend to cause sharper pain at onset, while tendon pain often develops more gradually.

Seek urgent medical advice if you develop:

Sudden severe pain with loss of strength or function
A popping or tearing sensation at the time of injury
Inability to weight bear or use the limb normally
Rapid swelling, bruising, redness, or fever

Common causes of tendon and soft-tissue pain

Tendinopathy

Tendon pain related to overload or repeated strain. Common examples include tennis elbow, Achilles pain, and patellar tendon pain. Tendinopathy usually develops gradually and may persist without appropriate rehabilitation.

Muscle strain

Occurs when muscle fibres are overstretched or overloaded. This can happen suddenly during lifting, sprinting, or awkward movement. Pain is often immediate and may be associated with weakness or bruising.

Plantar fasciitis

Pain at the bottom of the heel, often worse with the first steps in the morning. It is related to overload of the plantar fascia rather than inflammation alone.

Overuse and repetitive strain

Common in both sport and work related settings, particularly with repetitive tasks, poor conditioning, or sudden changes in workload.

Why tendon and muscle pain develops

Contributing factors often include:

Sudden increase in activity or training intensity
Reduced strength or conditioning
Inadequate recovery between activity
Poor load management
Changes in footwear or work demands
Biomechanical factors such as altered gait or posture

These conditions are rarely caused by a single structural failure. They usually reflect how tissues respond to repeated load over time.

GP top tips to keep tendons healthy in the workplace

Build in micro breaks: change position or task every 30 to 60 minutes if your role is repetitive.
Reduce grip overload: use larger handled tools, avoid sustained gripping, and keep wrists in a neutral position where possible.
Warm up before heavy tasks: a few minutes of gentle movement and light loading helps tissues tolerate strain.
Progress load gradually: sudden increases in lifting, typing volume, or manual work are a common trigger for flare ups.
Prioritise recovery: sleep, hydration, and rest days matter for tendon adaptation, especially during busy periods.
Do not ignore early warning signs: morning stiffness or pain after activity often means the tendon is overloaded.

If symptoms persist despite adjustments, a GP or physiotherapist can help confirm the diagnosis and provide a structured rehabilitation plan.

How a GP assesses tendon and soft-tissue pain

A GP assessment usually includes:

Location and nature of pain
How symptoms started and progressed
Activities that worsen or ease pain
Functional limitations
Swelling, bruising, or weakness
History of similar problems

Most cases can be assessed clinically without immediate imaging.

Investigations

Investigations are not usually needed initially.

Imaging or further tests may be considered if:

Symptoms are severe or worsening
There is concern about rupture or significant tear
Pain is not improving despite appropriate rehabilitation
The diagnosis is unclear

Scans are used selectively to guide management, not as a first step.

Scans can be used selectively to guide management.

Self-care and early management

Helpful early measures include:

Temporary reduction of aggravating activities rather than complete rest
Gradual reintroduction of movement and loading
Ice or heat for symptom relief
Supportive footwear for lower limb problems
Gentle stretching where appropriate

Recovery often takes weeks to months, particularly for tendon problems.

Medical treatments a GP may recommend

Depending on symptoms, a GP may recommend:

Discussions around pain relief
Advice on activity modification
Referral for physiotherapy
Further assessment if recovery is not progressing

The aim is to restore movement and function safely.

Expert physio insights by AccessGP Lead Physiotherapist, Sonali Talwar

Sonali is an experienced physiotherapist working with AccessGP. In her clinical practice, tendon and muscle injuries improve best when patients move away from prolonged rest and instead follow a structured, progressive rehabilitation plan.

Muscle strains often recover with gradual return to activity, while tendon pain usually requires longer term load management and strengthening. Physiotherapy focuses on rebuilding tissue capacity, correcting movement patterns, and helping patients return to work or sport safely, rather than relying on short term symptom relief alone.