Tendinopathies

A painful Achilles can really take the spring out of your step.
There are many tendons that can get in the way of the things we enjoy doing. Tennis and golfer’s elbow, jumper’s knee and rotator cuff tendinopathy are other common conditions that involve a grumbling tendon. To understand how to manage and recover from these injuries, it is important to know a bit more.

Tendons are strong and fibrous, connecting muscles to bone. When muscles contract, it’s the tendon that pulls on the bone to produce the movement. The muscle has 
an excellent blood supply and adapts very quickly when you start exercising to improve fitness and strength. The tendon is the non-contractile bit which is slower to adapt to training. The blood circulation in the tendon is not as prolific and the tendon's collagen takes longer to toughen up.

Though slower to transform than muscle, the increase in tendon resilience is a marvelous design feature that, if trained correctly, can develop a very high capacity to handle tension and dissipate load.

The difference between how quickly muscles and the tendons respond to our fitness training, make tendons particularly prone to overuse and injury. The other phenomena that is tricky to navigate, is that if we overload a tendon today, it might only start to complain in a few days. That is why if we begin a new program, we should not increase our efforts according to how our muscles feel.

In order to avoid a grumpy tendon apply the following physiotherapy strategy to your training program (we'll use a walking program as an example):

Firstly, estimate the average minutes walked over the previous 4 weeks. The walking volume decision for the current week should not increase by more than 20% of that average. You can take the volume as low as a 10% increase, but no higher than 30% of an increase.


Secondly, because tendons take a few days to complain about load they didn’t like, we have often have done way too much by the time pain alerts us. As a rule, two days off after any bout of exercise will protect the tendon.

Thirdly, use pain to guide decisions. Comfortable discomfort is nothing to worry about, but our activities should not push pain beyond a minor niggle.

Being too brave and pushing through pain will just make things worse but curling up in a ball and avoiding fitness will leave you in a deconditioned mess. These strategies create the right environment for a grumbling tendon to begin its journey back towards healthy function.

At Target Physio, we then apply a complex combination of manual therapy, evidence-based isometric, concentric and eccentric exercises as well as biomechanical improvements and load redistribution.

Many athletes, both young and old, will attest, the sophisticated program offered at Target Physio, allowing fitness to continue or be restored while the tendon settles. To book your unhappy tendon in for an assessment phone on 32025216 or click here to book online.

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