Tendon injuries: from rehab to performance
Tendinopathy, often known as tendinitis, is one of the most frequent ailments sustained by sports and gym-goers. However, this name is technically wrong since ‘itis’ indicates inflammation, which is not regarded to play a significant part in most tendon disorders.
Tendinopathy is an overuse injury to the tendon that leads to collagen degradation (the main structural component of the tendon). It is thought to happen when too much tension is exerted on the tendon with insufficient time for it to recover/adapt favorably to this stress. Tendinopathy pain is often greater in the hours after exercise or the next day rather than during activity when it tends to ‘warm up’/become less painful as exercise continues.
The patellar tendon (knee), Achilles tendon, hamstrings, biceps, wrist flexors/extensors (which join proximally on the inside and outside of the elbow, respectively), and rotator cuff are all common sites for tendinopathy. This essay will concentrate on patellar tendinopathy.
**The most essential thing to remember about these injuries is that COMPLETE REST DOES NOT HELP, NOR DOES JUST PUSHING THROUGH THE PAIN***.
This is unlike most other ailments, which tend to recover with rest over time. Tendons, on the other hand, MUST BE LOADED IN ORDER TO PROGRESS. The tough aspect is determining the proper quantity of loading! When they are overburdened, they often flare up and the discomfort worsens. They don’t improve if there isn’t enough load.
So, in this blog, I’d want to offer a tendon loading regimen that is both research-based and one that I’ve found to work well in my clinical practice.
The loading instructions are provided below.
- Begin with isometric holds in the mid-range for whichever muscle/tendon is bothering you (e.g. wall squat hold quarter to halfway down for the patellar tendon). Maintain for 30-45 seconds. Do two sets twice a day (e.g. 2 in the morning and 2 in the evening). Use a degree of resistance that permits you to complete the hold with less than a 3/10 level of discomfort. Don’t push through the anguish any farther. Depending on how much force you can bear, this might entail doing the wall squat on two or one legs. Do this for a week, increasing resistance as you can within your pain limitations. Isometrics are excellent early in tendon rehab since they have been demonstrated to be particularly effective for pain alleviation (1).
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