At Altius Physical Therapy, one of the most common questions we hear from patients recovering from tendinopathies—like shoulder, elbow, hip, knee, or Achilles tendon pain—is:
“Should I stop if it hurts?”
The answer? Not always.
Some discomfort during rehabilitation can be acceptable, particularly when we’re gradually loading an irritated tendon. The key is understanding how much pain you’re experiencing, how your body responds afterward, and whether you’re making progress over time.
Here’s what you should know about exercising with tendon pain.
Research supports using symptoms to help guide exercise progression during tendinopathy rehabilitation. Rather than avoiding every uncomfortable movement, we look at a few important factors.
A commonly used guideline is to keep exercise-related pain around 4 out of 10 or less.
This isn’t a universal safety cutoff. What matters is the type of injury, your individual symptoms, and how you respond to loading.
Some discomfort may be acceptable, but pain shouldn’t steadily increase as you continue exercising.
A little soreness after exercise isn’t necessarily a problem.
Ideally, symptoms should return close to your usual baseline by the following day. If pain is noticeably worse, persists longer than expected, or begins affecting sleep or everyday activities, we may need to adjust the exercise.
Don’t judge your recovery by one good or bad day.
Instead, look at the bigger picture. Are you getting stronger? Can you tolerate more activity? Are everyday movements becoming easier?
Those improvements matter, even if you’re still experiencing occasional discomfort.
Not all pain is something to push through.
Talk with your physical therapist and consider modifying your exercise if you experience:
Sharp or sudden pain during activity
Pain that progressively increase
s with each repetition
New or increasing swelling
A noticeable loss of strength or movement
Worsening pain at rest or during the night
Symptoms that remain significantly worse the following day
Sudden severe pain, a popping sensation, or an abrupt loss of function may indicate an injury requiring prompt medical evaluation.
The goal isn’t to ignore pain. It’s to understand what your symptoms are telling us and adjust accordingly.
Tendons respond to progressive loading. Appropriate strengthening helps improve their ability to tolerate the demands of everyday activities, exercise, and sports.
For many tendinopathies, complete rest isn’t the best long-term solution. Likewise, requiring every exercise to be completely pain-free isn’t always necessary.
That doesn’t mean pain is required for progress.
We want to find an exercise intensity that challenges the tendon without creating an excessive or prolonged increase in symptoms.
Some discomfort may be okay. A worsening response is a reason to adjust.
Keeping pain around 4 out of 10 or less and returning close to your normal symptom level within 24 hours can be useful guidelines for certain tendon conditions.
But they’re not rigid rules for every patient or every injury.
Your overall progress and response to exercise should guide your rehabilitation.
At Altius, we help patients understand what discomfort may be acceptable, when to modify an activity, and how to progressively build strength and function.
Your treatment is based on your specific condition, activity goals, and response to exercise—not simply a number on a pain scale.
If you’re dealing with persistent tendon pain or aren’t sure whether you should keep exercising, we’re here to help.
**Contact Altius Physical Therapy in Park Ridge, NJ to schedule an evaluation and get a clearer plan for moving forward.