Tendinopathy can result from overuse and is experienced in the affected tendon as pain with activity, focal tenderness to palpation, and decreased ability to tolerate tension, which results in decreased functional strength. While tendinopathy often occurs in those who are active, it can occur in those who are inactive. Research has shown that an eccentric exercise program can be effective in the treatment of tendinopathies. The earliest studied was the Achilles tendon, and subsequent studies have shown benefits using eccentric exercises on other body regions including the patellar tendon, proximal lateral elbow, and rotator cuff. In this article, we review the research on using an eccentric exercise program in the treatment of painful tendinopathy and proposed mechanisms for why eccentric exercises are effective in treating this and then finish by providing a general framework for prescribing an eccentric exercise program to those with a symptomatic tendinopathy.