During growth spurts, bones lengthen faster than muscles and tendons can adapt. This increases tension through tendons and reduces load tolerance. As a result, activities that were previously well tolerated can suddenly provoke pain. Importantly, tendon pain in young athletes rarely reflects tendon degeneration or structural damage.

A common response is complete rest, but prolonged unloading often leads to deconditioning and delayed recovery. Current best practice focuses on modifying load rather than stopping activity altogether. Reducing training volume,adjusting intensity, or temporarily limiting provocative activities allows symptoms to settle while maintaining overall fitness.

Progressive strengthening is central to tendon rehabilitation. Strength training improves tendon capacity and reduces pain when appropriately prescribed. In young athletes, programs must be age-appropriate and supervised, focusing on technique and gradual progression..

Education is critical for both athletes and parents. Understanding that some discomfort during rehabilitation is acceptable reduces fear and improves adherence. Pain should be monitored, but it does not necessarily mean harm.
Early intervention leads to better outcomes. Addressing tendon pain early prevents progression to chronic symptoms and prolonged time away from sport. The aim is to support continued participation while protecting long-term tendon health.