A Function-Based Approach to Tendon Rehabilitation: Comparing Upper- and Lower-Limb Tendinopathies

Tendinopathies affect tendons exposed to diverse mechanical and functional demands. This structured narrative review examines rehabilitation principles for Achilles, patellar, lateral elbow, and rotator cuff tendinopathy, while distinguishing evidence derived from individual conditions from cross-condition inferences. Progressive exercise and load management are recurring treatment principles, but direct comparisons across tendon locations are scarce. The proposed function-based framework brings together symptom irritability, load tolerance, and the demands of the target activity as prompts for clinical reasoning; it does not prescribe a fixed exercise sequence. The contrast between precision tasks and elastic energy storage is best understood as a continuum. Exercise selection, neuromuscular strategies, and late-stage power work should follow the individual patient’s task demands and the evidence available for that condition. The framework synthesizes existing models rather than establishing a new treatment effect. Its comparative predictions and clinical benefit require prospective testing. Interpretation is limited by heterogeneous evidence and the absence of a completed study-level risk-of-bias assessment in the available review record.