Muscle vs Tendon Pain: What You’re Really Feeling and How to Treat It

Muscle aches and tendon pain are two of the most common reasons people seek help for discomfort, stiffness, or limited movement. Yet the difference between them is often misunderstood. Many people assume all soreness is “muscle pain,” when in reality the source may be a tendon, one of the dense, fibrous tissues that connect muscle to bone. Understanding the difference matters because muscle and tendon injuries respond differently to treatment.

Whether you’re dealing with a tight calf after a long run, nagging inside of knee pain after sitting too long, or a sharp pull in your shoulder when reaching overhead, identifying the true source of your symptoms is the first step toward effective relief.

In this guide, we’ll break down exactly how muscle pain differs from tendon pain, how to recognize each, the best treatment options, and what to do when pain doesn’t go away on its own.

What’s the Difference Between Muscle Pain and Tendon Pain?

Muscle Pain: What It Actually Feels Like

Muscles are soft, contractile tissues designed for movement. Because they receive a strong blood supply, they heal relatively quickly. Common causes of muscle pain include overload at the gym, poor posture, stress tension, or sudden over-stretching.

Muscle pain typically feels:

• Achy or dull
• Sore when you stretch the area
• Tender across a broad region
• Better after movement or gentle heat
• Worse when the muscle contracts strongly

A hallmark sign of muscle pain is delayed-onset muscle soreness (DOMS): that classic “I worked out too hard” feeling that peaks 24–72 hours after activity. This type of pain is usually harmless and short-lived.

Tendon Pain: How It Differs

Tendons are thick, rope-like structures made of collagen. They anchor muscles to bone and absorb impact with every movement you make. Unlike muscles, tendons receive less blood flow, which means they heal more slowly.

Tendon pain (often called tendinopathy or tendonitis, depending on severity) has a very different profile:

• Sharper, more pinpoint pain
• Pain in a small, specific location
• Worse with repetitive loading (walking, gripping, jumping)
• Worse in the morning
• Improves slightly as you warm up
• May swell or feel thickened

Unlike muscles, tendons do not like prolonged stretching; too much stretching can even make tendon pain worse.

Why It’s Easy to Confuse Muscle and Tendon Pain

Referred Pain

Muscles and tendons often share nerve pathways, which can make it confusing to pinpoint the exact source of pain. For example:

• A tight hip muscle can cause inside of knee pain.
• A calf strain can create discomfort behind the knee.
• Shoulder tendons can mimic neck muscle tension.

Compensation Patterns

When one tissue becomes irritated, nearby areas tend to compensate. A strained muscle may overload a tendon. A weak tendon may force surrounding muscles to work harder. This creates a tangled pattern of symptoms that can feel like “everything hurts.”

Pain Feels Similar When You Move

Because tendons activate when muscles contract, movement-based pain can overlap. A simple squat or step might hurt whether a tendon or muscle is involved.

For these reasons, a proper assessment is often the most important step in determining the true source of your discomfort.

Common Locations of Muscle vs Tendon Pain

Inside of Knee Pain

One of the most confusing locations is the inner side of the knee, because multiple muscles and tendons attach in that area.

Common tendon-related causes of inner knee pain include:

• Pes anserine tendinopathy

• Medial collateral ligament (MCL) irritation

• Hamstring tendon overload

Muscle-related causes often include:

• Tight inner thigh muscles
• Weak hip stabilizers
• Overworked quadriceps

   

If you have inside of knee pain when climbing stairs, rising from a chair, or standing after sitting for a while, the source may be a tendon. If the pain feels broad, sore, or improves with heat, a muscle is more likely involved.

Shoulder Pain

Shoulder tendons, especially the rotator cuff, are notorious for irritation. Tendon pain is usually sharp when you lift your arm overhead, reach behind your back, or sleep on the affected side. Muscle pain, however, tends to feel like tightness along the upper back, neck, or outer shoulder.

Achilles and Calf Pain

The Achilles tendon, which connects the calf muscles to the heel, is one of the most stressed tendons in the body. Tendon pain here is typically stiff in the morning, sore during activity, and aggravated by running or jumping. Calf muscle pain, by contrast, feels more diffuse and improves with stretching.

How to Tell Whether It’s Muscle or Tendon Pain (At Home)

While a professional exam is the most accurate way to diagnose your issue, the following self-tests can offer useful clues:

1. Try Stretching the Area

• If stretching feels good → Muscle issue is more likely
• If stretching hurts or feels sharp → Likely tendon irritation

2. Apply Light Pressure

• Broad soreness across a wider area → Muscle

• Pinpoint, specific tenderness → Tendon

3. Notice When It Hurts Most

• Pain during contraction or after exercise → Muscle

• Pain first thing in the morning or with repetitive motion → Tendon

4. Check for Swelling or Thickening

Tendon pain may come with visible swelling or a rope-like thickened area. Muscle soreness generally does not.

Best Treatments for Muscle Pain

1. Heat Therapy

Muscles respond exceptionally well to heat. A warm compress, hot shower, or heating pad increases blood flow and reduces stiffness.

2. Gentle Stretching

Slow, controlled stretching helps muscle fibres lengthen and relax. Stretching should feel relieving, not painful.

3. Light Movement

Walking, cycling, or mobility exercises can boost circulation and speed up healing.

4. Massage or Foam Rolling

These techniques reduce muscle tension and break up adhesions. Foam rolling works best when applied to large, broad muscle groups.

5. Topical Products for Pain Relief

A muscle pain relief cream can be helpful for short-term comfort. Ingredients like menthol or arnica create a soothing effect that eases soreness and tension.

6. Rest from Overloading Activities

Muscle strains often improve simply by avoiding the aggravating activity for a few days.

Best Treatments for Tendon Pain

Tendons are pickier than muscles and require a different approach.

1. Reduce Aggravating Movements

Immediately stop the specific repetitive motions causing pain, running hills, jumping, heavy lifting, etc.

2. Avoid Long Static Stretching

Unlike muscles, stretching does not heal tendons and can worsen irritation.

3. Use Ice for Flare-Ups

Ice can reduce sharp pain or swelling after activity.

4. Start Controlled Loading (The Most Important Step)

Once acute pain settles, tendons need gradual, progressive loading to heal properly. Examples include:

• Isometric holds
• Slow eccentric exercises
• Controlled resistance movements

This loading helps the tendon rebuild collagen structure and regain strength.

5. Try Supportive Bracing

A brace or strap can offload pressure on the tendon during activity.

6. Seek Professional Treatment

If pain persists, tendon issues may need targeted therapy such as shockwave therapy, platelet-rich plasma (PRP), or guided exercises under the supervision of a specialist.

When to Seek Help for Persistent Muscle or Tendon Pain

Self-care strategies work well for minor strains and mild soreness. However, you should seek help if:

• Pain lasts longer than 2–3 weeks
• Pain interferes with daily activities (walking, climbing stairs, work tasks)
• Symptoms worsen instead of improving
• There is swelling, instability, or a catching sensation
• Inside of knee pain persists despite rest

This is especially important for tendon pain, which can worsen over time if left untreated.

Professional Support for Knee, Muscle, and Tendon Pain in Toronto

If your pain, whether in the knee, shoulder, back, or another joint, has lasted more than a few weeks or is affecting your mobility, getting a proper assessment is key to stopping the cycle before it becomes chronic.

At Silver Pain Centre, we take a personalized, evidence-based approach to diagnosing and treating muscle and tendon-related pain, including inner knee pain, tendon irritation, muscle strains, and chronic overuse injuries.

Why Patients Choose Us

Our 20,000 sq. ft. facility on Dufferin Street in North York offers:

• Shorter wait times

• Free parking

• OHIP-covered consultations and procedures

• Access to an entire team of pain specialists under one roof

This means you receive faster, coordinated care with experts who understand the complexities of muscle vs tendon pain.

Get Help for Knee and Soft Tissue Pain in Toronto

Whether your pain feels like a deep muscle ache, a sharp tendon pull, or stubborn inside of knee pain that just won’t go away, we’re here to help you regain comfort and mobility.

Visit us at:
4646 Dufferin Street, Unit #9, Toronto, ON M3H 5S4

Call:
(416) 512-6407