Rest, Rehab, or Reload? What Tendons Need at Every Healing Stage

When a tendon gets injured, the first instinct is often rest — and lots of it.

But rest alone isn’t enough to repair tendon tissue. In fact, too much rest can actually make recovery slower and increase the risk of reinjury down the road.

So what does a tendon actually need to heal well?

Let’s break it down stage-by-stage:

Stage 1 — The Inflammatory Phase: Do You Really Need to Rest?

Timeline: First 2–7 days Goal: Protect & control inflammation — not eliminate it

When a tendon is injured, your body sends fluid, immune cells, and growth factors to the area. This is not a mistake. It’s how healing begins.

What Tendons Need:

• Relative rest (not total immobilisation)

• Pain-managed movement

• Avoiding heavy loads or stretching

What Helps:

• Compression

• Controlled activity

• Elevation

• Gentle isometrics (pain-free holds)

What Usually Hurts:

• Too much ice

• Anti-inflammatories taken too early

• Total rest or bracing for too long

The bottom line: Rest? Yes — but only enough to calm things down, not shut the system down.

Stage 2 — The Proliferation Phase: Time to Rehab

Timeline: Day 5 to Week 6 Goal: Help new collagen fibres grow strong and organised

Now the body is building new tendon tissue, but it’s messy — like a spiderweb instead of a rope.

This stage is where we shift from “protecting” to “guiding.”

What Tendons Need:

• Light loading

• Pain-guided movement

• Low to moderate intensity exercises

What Helps:

• Isometric exercises progressing to isotonic (slow lifts)

• Slow, controlled loading

• Tendon-specific exercise protocols

What Hurts:

• Avoiding movement

• Jumping back into sport

• Pushing through sharp pain

Key idea: Tendons heal by being loaded. But only the right kind of load, at the right time.

Stage 3 — Remodelling Phase: Reload and Rebuild

Timeline: Week 6 to Month 12+ Goal: Make tendon fibres stronger, denser, and aligned for real-life stress

This is where the new collagen gets stronger — if you challenge it properly.

What Tendons Need:

• Progressive loading

• Real-weight, real-movement strength

• Plyometrics (eventually)

• Return-to-sport conditioning

What Helps:

• Heavy slow resistance training

• Eccentric exercises

• Gradual return to speed, power, and impact

What Hurts:

• Staying in "rehab mode" too long

• Stopping strengthening after pain disappears

• Jumping straight back into sports intensity

The big mistake: People feel better and stop rehab early — but the tendon isn’t truly strong yet.

So When Is It Safe to Reload?

A tendon is ready for progressive loading when:

• Daily movement feels okay

• Pain is mild (1–3) and improving

• Loading doesn't produce next-day flare-ups

• You can move through full or nearly-full range

The Modern Rehab Model: PEACE & LOVE

A newer approach that replaced RICE:

PEACE (for the early phase):Protect • Elevate • Avoid anti-inflammatories • Compress • Educate

LOVE (for recovery and beyond):Load • Optimism • Vascularization • Exercise

Or simply:

Rest when needed. Rehab with purpose. Reload to return stronger.

Final Takeaway

Tendon healing is not passive. It’s a dance between recovery and reloading.

• Too much rest? Tendon gets weaker.

• Too much too soon? Tendon gets irritated.

• Loaded progressively over time? Tendon comes back stronger than before.

Respect the stages. Work with your biology — not against it. And remember: movement, not stillness, is what makes tendons thrive.