What Is Tendinopathy (and Why Atlanta Runners Get It So Often)?
First, runners need to understand the difference between tendinitis and tendinopathy. Most running-related tendon pain isn’t as simple as just some inflammation (acute tendonitis). It’s more likely to be tendinopathy which is where the tendon’s ability to tolerate load has broken down over time.
Tendons connect muscle to bone and their job is to store and release energy. When you lace up their shoes and go out for a run, you’re asking your tendons to repeatedly store & release energy thousands of times. When the demand/load placed on a tendon exceeds its current capacity, pain shows up.
This often happens gradually due to:
Sudden mileage increases
More speed work or hills (shoutout Atlanta hills)
Changes in terrain
Changes in shoes
Loss of strength or coordination
The tendon doesn’t just get “injured” in one bad step in the majority of cases; it slowly becomes overloaded, then reactive, then painful. And tendinopathy develops.
Why Rest Alone Doesn’t Fix Tendon Pain in Runners
This is where most Atlanta runners get it wrong. They start to get some tendon pain and decide that taking off a few days is what they need.
The issue with this is while rest may reduce symptoms temporarily, it doesn’t increase the tendon’s capacity. In fact, too much rest can make tendons less tolerant to load.
So what happens?
You rest → pain improves
You return to running → pain comes back
You rest again → cycle repeats
This is why runners come into our clinic and often say: “It feels fine until I run.”
Tendons don’t heal through avoidance; they heal through progressive, well-timed loading. That’s where running-specific physical therapy becomes critical. Working with a running specialized physical therapist who understands how to progressively load the tendon to meet the demands of running is key in getting you out of the running injury cycle.
The Most Common Tendon Injuries We See in Atlanta Runners
While tendon pain can occur in a number of places for runners, these are the most common tendinopathies we treat at our Atlanta-based clinic:
Patellar Tendinopathy (Front-of-the-Knee Pain)
Often triggered by:
Speed work
Hills
Downhill running
Quad strength deficits
Read the full guide: Patellar Tendinopathy in Runners
Achilles Tendinopathy
One of the most common running injuries overall, especially in runners increasing mileage or intensity.
Often linked to:
Calf weakness
Limited ankle mobility
Sudden changes in training load or shoes
Read the full guide: Achilles Tendinopathy in Runners
Gluteal Tendinopathy (Lateral Hip Pain)
Common in runners who:
Run on cambered roads
Train on hills
Lack pelvic and hip stability
PT Tip: This running injury is often confused with IT band syndrome.
Read the full guide: Gluteal Tendinopathy in Runners
Proximal Hamstring Tendinopathy
Felt as deep butt or upper hamstring pain, often worsened by:
Speed work
Hills
Sitting for long periods
Read the full guide: Proximal Hamstring Tendinopathy in Runners
Why Running Specific Physical Therapy Matters for Atlanta Runners
Not all physical therapy is the same and this matters a lot for runners dealing with tendon injuries. Traditional physical therapy clinics often focus on passive treatments such as stretching or they recommend a runner take “complete rest”. But we understand what a runner needs:
Progressive strength loading
Running gait assessment
Load management guidance
Return-to-run planning
At Tempo Physical Therapy & Performance, our approach to running specialized physical therapy for Atlanta runners includes:
Strength testing specific to running demands
Gait analysis to identify mechanical contributors
Tendon-appropriate loading progressions
Running-specific return-to-training strategies
Our goal isn’t just pain relief; it’s helping you run stronger than before.
Common Mistakes Runners Make With Tendon Injuries
We see these mistakes repeatedly:
Resting until pain disappears, then jumping back in
Stretching irritated tendons aggressively
Ignoring strength deficits
Changing shoes without addressing mechanics
Continuing to train through pain without guidance
These often turn a manageable issue into a chronic one. Check out our blog on why runners shouldn’t wait to see a running specialized physical therapist when they start to notice pain.
How Runners Can Train Smarter With Tendon Pain
While every runner is different, successful tendon rehab usually includes:
Temporary training modifications (not full shutdowns)
Heavy-slow or progressive strength loading
Improved running mechanics
Gradual return to speed and hills
Consistent monitoring of symptoms
This is why having a running-specific PT involved early makes a big difference. The structured guidance makes it so that you don’t have to keep guessing at what’s best for your tendon pain as a runner. You get clarity on next steps and typically get back to pain free running sooner.
When Should Atlanta Runners Seek Help for Tendon Pain?
If you’re experiencing:
Pain lasting longer than 2–3 weeks
Pain that returns every time you run
Morning stiffness or post-run soreness
Difficulty with hills or speed work
It’s time for a professional evaluation by a running specialized physical therapist. Early intervention leads to faster recovery and fewer setbacks.
Running Physical Therapy in Atlanta: How We Help
At Tempo Physical Therapy & Performance, we help runners across Atlanta, Sandy Springs and surrounding areas overcome tendon injuries without losing their identity as runners.
Our tendon rehab process includes:
Detailed movement and strength assessment
Running gait analysis
Individualized strength programming
Education so you understand why pain is happening
A clear path back to training
If you’re tired of guessing, resting or starting over, we’re here to help. Learn more about our running specialized physical therapy services for Atlanta runners
What’s Next in This Tendon Injury Series
Use the guides below to dive deeper into your specific injury:
Patellar Tendinopathy in Runners
Achilles Tendinopathy in Runners
Gluteal Tendinopathy in Runners
Proximal Hamstring Tendinopathy in Runners
Each blog post breaks down exactly what runners need to know (and do) to recover fully.
Final Thought
Tendon injuries don’t mean you’re broken. They just mean your body needs a smarter approach to load. With the right plan and the right guidance, most runners don’t just recover, they come back stronger, more efficient and more resilient.
If you’re looking for running physical therapy in Atlanta, we’d love to help you get there. Go ahead and book a FREE consultation call with us where we will talk more about your specific injury and discuss next steps towards pain free running.
