The race bibs are pinned to the corkboard, the bike is spending more time on the trainer than on Flagstaff, and the first snow has dusted the Flatirons. For a lot of Boulder athletes, this is the quieter stretch of the year. It's also the perfect excuse to finally address that nagging tendon pain.
You know the one. The Achilles that's stiff for the first few steps every morning. The knee that grumbles on descents. The elbow that's been "a little cranky" since your third climbing session in a row back in June. You managed it all season because you had goals, races, and adventures you weren't willing to miss. But now that the calendar has opened up, it's time to give that tendon some focused attention. Here's why addressing persistent tendon pain during the off-season can pay off when your training ramps up again.
Rest Helps. Strength Helps It Stick.
Sometimes an irritated tendon needs a temporary reduction in activity, and that's okay. For some people, particularly those with less demanding activity goals, reducing aggravating movements may be enough for symptoms to settle. For others, rest can calm things down but doesn't always prepare the tendon to handle those same demands when they return.
That's where progressive strengthening comes in. Tendons respond to load, and when that load is introduced gradually and consistently, they can adapt to handle greater demands. However, when training involves sudden increases in volume, intensity, or unfamiliar terrain, those demands can exceed what a tendon is currently prepared to tolerate.
During the competitive season, finding room for a structured strengthening program can be challenging. Between long runs, climbing sessions, races, and recovery days, there isn't always much flexibility. The off-season gives you room to ease off irritating activities while putting more time and energy into building strength and improving your tendon's ability to tolerate load.
Time Is on Your Side
Tendons generally adapt more slowly than muscles. Meaningful improvements in tendon capacity often require consistent loading over several months, which is one reason mid-season quick fixes can feel like a game of whack-a-mole. The good news is that you don't need to wait until your symptoms are completely gone to start making progress.
With fewer races and big training weekends on the calendar, there's often more flexibility to build a rehabilitation program that progresses at the pace your tendon needs. Rather than trying to squeeze strengthening exercises around peak training demands, you can gradually increase resistance, monitor how your tendon responds, and build toward the specific activities you want to return to. That consistency can make a big difference when your training volume picks up again.
Keep Moving (We Know You Will)
Let's be honest: nobody in Boulder is spending the entire winter on the couch. Between ski days, trainer rides, running, climbing, and the gym, you're probably going to stay active. And that's generally good news for your tendon, too. One of the biggest misconceptions about tendon rehabilitation is that you need to stop exercising until you're completely pain-free.
Research on Achilles tendinopathy has shown that athletes can often continue participating in their sport during rehabilitation by following a pain-monitoring approach. Some discomfort during activity may be acceptable, provided symptoms return to baseline afterward and aren't progressively worsening. Monitoring next-morning pain and stiffness can be particularly helpful in determining whether you're doing too much. Of course, the amount and type of activity that's appropriate will depend on the tendon involved, your symptoms, and your current training demands.
A physical therapist can help you determine which activities to modify, which ones to continue, and how to gradually increase loading without repeatedly aggravating symptoms. The goal isn't necessarily to do less. It's to find the right amount of activity to keep you moving forward.
What Off-Season Tendon Rehabilitation Might Look Like
There's no one-size-fits-all approach to tendon rehabilitation. The right exercises, loading strategy, and progression depend on which tendon is involved, how long symptoms have been present, and what activities you're trying to return to. A good off-season rehabilitation plan might include:
Isometric holds. Static contractions, like holding a calf raise or wall sit, can be a useful starting point when a tendon is particularly sensitive. These exercises allow us to introduce load in a controlled way while building tolerance for more challenging movements.
Heavy, slow strength work. Progressive resistance training is a cornerstone of tendon rehabilitation. As your tolerance improves, we gradually increase resistance to help the tendon and surrounding muscles handle greater demands. Think controlled, deliberate repetitions rather than flashy gym circuits. Depending on the tendon and your symptoms, heavier strengthening may be appropriate relatively early in rehabilitation.
Gradually adding speed and spring. Tendons do more than tolerate heavy loads. They also store and release energy during activities like running, jumping, and hopping. Once you've developed an appropriate strength foundation, exercises that introduce faster movements and elastic loading can help prepare your tendon for the demands of your sport. For runners, this might include hopping, bounding, or jumping progressions. For other athletes, the focus may be on different movements that more closely reflect their sport.
A smart return-to-sport plan. Building strength is important, but so is knowing how to apply it. Gradually reintroducing hills, speedwork, longer training sessions, or more demanding climbing routes helps bridge the gap between rehabilitation exercises and the activities you enjoy. The goal is to return to your normal training with greater capacity and confidence rather than jumping straight back into the same demands that aggravated your symptoms.
Focused shockwave therapy, when appropriate. For certain persistent tendon conditions, including Achilles tendinopathy and lateral elbow pain, focused shockwave therapy may be a helpful addition to a progressive rehabilitation program. Shockwave therapy has also shown benefits for conditions like plantar fasciopathy, a common cause of persistent heel pain. While it's not a replacement for strengthening and load management, it may provide another option when symptoms aren't improving as expected.
A Few Signs Your Tendon Is Asking for Attention
Not sure whether that nagging pain is worth looking into? Some common signs of tendinopathy include:
Morning stiffness: Pain or stiffness first thing in the morning or after sitting that improves as you start moving.
Persistent symptoms: Pain that's been hanging around for several weeks or keeps returning each training season.
Localized discomfort: Pain concentrated around a specific area, such as the Achilles tendon, just below the kneecap, or the outside of the elbow.
Activity-related flare-ups: Symptoms that increase after hills, speedwork, jumping, or harder climbing sessions.
Changes in training tolerance: Activities that used to feel manageable are becoming increasingly uncomfortable or require more recovery time.
These symptoms aren't exclusive to tendinopathy, which is why getting an accurate assessment matters. If any of these sound familiar, the off-season is an ideal time to figure out what's contributing to your symptoms and build a plan to address them.
Spring You Will Say Thanks
There's something satisfying about heading into a new season feeling ready for it. Instead of crossing your fingers during your first long run or big climbing day, you can approach your training knowing you've spent the winter building strength and capacity.
So enjoy the slower pace, the cozy trainer rides, and the powder days. With time, consistency, and the right loading plan, that nagging tendon can be ready for whatever adventures are on your calendar next. And if it's been lingering longer than you'd like, we're happy to help you figure out why.
Boulder Sports Physiotherapy works with runners, cyclists, climbers, and active people throughout the Boulder area. You can book online anytime through our website.
Further ReadingF
Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med. 2009;43(6):409–416.
Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study. Am J Sports Med. 2007;35(6):897–906.
Rio E, Kidgell D, Purdam C, et al. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med. 2015;49(19):1277–1283.
Beyer R, Kongsgaard M, Hougs Kjær B, et al. Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized controlled trial. Am J Sports Med. 2015;43(7):1704–1711.
Malliaras P, Barton CJ, Reeves ND, Langberg H. Achilles and patellar tendinopathy loading programmes: a systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness. Sports Med. 2013;43(4):267–286.