After maturation tendons undergo many biochemical, cellular, mechanical and pathological changes that bring about a general decline in the structure and function of the tendon. This decline in the aging tendon is characterized by a reduced ability to adapt to environmental stress and loss of tissue homeostasis. The tendon's adaptability to these changes will decide the rate and the success of treatment of a tendon injury. This review examines these changes and also looks at how we can curtail their progression through exercise and lifestyle modification.