Tendinopathies in Mendrisio: why progressive load is the key to recovery (elbow, shoulder, knee, gluteal region, wrist)

Tendon pain is one of the most frequent conditions, both in athletes and in people who are active or who do repetitive work. One of the most common sources of confusion concerns the difference between “tendinitis” and “tendinopathy”. In everyday language people often speak of inflammation, but in most cases we are not dealing with an acute inflammatory process, but rather with tissue that has lost its capacity for load and adaptation.

Understanding this difference completely changes the therapeutic approach, especially in the treatment of tendinopathy, where load management is the truly decisive element for recovery.

In acute tendinitis, inflammation is predominant.
In chronic tendinopathy, by contrast, the main problem is structural and functional: the collagen fibres are less organised and the tendon becomes less tolerant of mechanical stress.

This means that:

• pain appears with loads that were previously well tolerated
• rest temporarily reduces the symptoms
• returning to activity brings the pain back

In the treatment of tendinopathy, the goal is not to “switch off the inflammation”, but to rebuild the tendon’s capacity to withstand progressive load.

The literature describes three main phases.

Reactive phase: the initial response to a sudden overload. The tendon thickens and becomes more sensitive. This phase is potentially reversible.

Dysrepair phase: changes in the tendon matrix begin to appear.

Degenerative phase: the tissue shows more marked structural disorganisation.

In the tendinopathy pathway in Mendrisio, TI-FISIO identifies the clinical phase in order to set the intensity, progression and frequency of the load.

The tendon needs mechanical stimulus in order to maintain its structural quality.
Prolonged rest reduces the symptoms in the short term but worsens the capacity for adaptation in the medium to long term.

This is why many people:

• improve during the break
• get worse when they start again

In the management of tendinopathy in Mendrisio, TI-FISIO does not remove load: it doses it, structures it and makes it therapeutic.

The cornerstone of the TI-FISIO approach is progressive load based on the principles of Heavy Slow Resistance (HSR).

This means:

• slow exercises
• appropriate and progressive loads
• control of technique
• monitoring of the response over 24–48 hours

Pain is modulated, not completely avoided. Controlled symptoms can be compatible with recovery, provided they do not increase in the days that follow.

In the tendinopathy pathway in Mendrisio, TI-FISIO builds personalised programmes that evolve week after week, adapting to the patient’s response.

Treatment does not stop at exercise in the clinic.
TI-FISIO plans a gradual return to:

• manual work
• the gym
• running
• specific sports
• overhead activities

Managing load spikes is one of the most important elements in reducing recurrences. The goal is not only to recover, but to maintain the results over time.

When indicated, TI-FISIO includes shockwave therapy in the tendinopathy pathway in Mendrisio.

The purpose of shockwaves is to:

• stimulate neovascularisation
• promote collagen synthesis
• improve the biological response of the tissue

They do not replace progressive load.
They are a support in persistent tendinopathies or in those with a slow response to active treatment.

At the elbow (tennis elbow or golfer’s elbow), TI-FISIO works on:

• progression of load on the extensors or the flexors
• improvement of grip strength
• eccentric control
• gradual return to work activities

The key is not to stop, but to rebuild the tendon’s tolerance.

At the shoulder, tendinopathy often involves the rotator cuff.

The focus of TI-FISIO includes:

• progression of load on the cuff
• improvement of functional scapular control
• management of the subacromial space
• education on overhead movements

The problem is not the overhead movement in itself, but the system’s inability to manage load over time. The goal is to reduce friction and prevent recurrences by improving mechanical tolerance.

At the knee (patellar tendon) and the gluteal region (gluteus medius), TI-FISIO works with:

• closed kinetic chain exercises
• progression of loads
• control of lower limb dynamics
• management of training volumes

Here too the principle remains the same: structured progressive load.

For tendinopathy in Mendrisio at wrist level, TI-FISIO Mendrisio combines:

• specific strengthening
• ergonomic adaptation
• management of breaks
• gradual return to the repetitive movement

At TI-FISIO, the tendinopathy pathway in Mendrisio is based on:

• a detailed clinical assessment
• identification of the phase in the continuum
• a personalised Heavy Slow Resistance programme
• pain modulation
• planning of the gradual return

If you suffer from persistent pain in the elbow, shoulder, knee, gluteal region or wrist and suspect tendinopathy, contact TI-FISIO in Mendrisio for a thorough assessment and a tailor-made pathway aimed at real and lasting recovery.

+41 91 940 10 20

info@ti-fisio.ch

Via Ceresio 42, Pregassona.

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+41 (0)91 229 69 80

mendrisio@ti-fisio.ch

Via Giuseppe Motta, 6a, Mendrisio