There are many uncertainties over the exact pathophysiology of tendinopathies. With the emergence of new treatment modalities making decisions regarding management can be difficult. A systematic review conducted over the past 12 months highlights the benefits that surgery and physio have. Though the study shows very little difference between the two management techniques. The management techniques target the reduction of patient symptoms and improving function. The study has moderate level evidence and concludes that loading exercise treatment should be encouraged for at least 12 months before the idea of surgery is entertained.