The First Step Of Recovery Is Understanding What's Going On
Your tendons join your muscles to your bones. Their main role is to act like a stiff spring and transfer force.
A tendinopathy is when the tendon starts to degenerate via micro-tears in the tendon. Sometimes, there can be some inflammation present too. There are different types of tendinopathies and various stages, however, let’s talk about Tendinopathy in general terms.
The most common tendons that get overloaded are the achilles, the patella tendon (in the knee), the adductor (groin) and one or more of the rotator cuff tendons in the shoulder.
Without a doubt, the main cause of tendinopathy is overload.
You have just started preseason without having done any conditioning during the off season.
Or maybe it’s mid season and you’re trying to play hurling and football at junior and senior level.
Or maybe you are an experienced runner and you’re trying to beat your previous personal best in your (half) marathon, so you’ve been upping your training volume recently.
These are all common recipes for overload.
Body tissues have a load tolerance (strength). When the tolerance is exceeded on an ongoing basis, the tissues won’t be able to recover adequately.
Tendons take quite a bit longer to recover when compared to muscles. This is why the tendon gets overloaded and you feel the pain in your tendon rather than your muscle.
Generally, tendon pain presents as a niggly achilles or knee that comes on initially, after training or a game.
If left unaddressed, this can progress to becoming sore at the start of a training session or game, which will often go away as the area gets warmed up.
Then, when you exceed the amount of load the tendon can handle you may feel pain toward the end of your session and worse pain after the session/game which can last for a day or more.
If you continue to train, the pain in the tendon will become sharper and you will feel it more often, eventually impeding your ability to even jog lightly.
So, if overload is the causes of your tendon pain, what is the solution?
The frequency of tendon loading is vitally important, regarding exercise/sport and rehab (see picture).
Adequate rest/recovery in your weekly and monthly activity.
Your training volume needs to be assessed and managed, taking intensity, duration and frequency into account.
All of these factors need to be MANAGED perfectly.
While rest and recovery are both very important factors, you may also need to increase the ability of the muscle and tendon to tolerate force; in other words, increase the strength.
Progressive strengthening exercises are pivotal for tendinopathies.
They need to be done at the right times too to optimise recovery and adaptation.
Overload is the main cause of tendinopathy, however there can be a lot of other contributing factors.
- Ankle, knee and hip muscle weakness/imbalances
- Stiffness in the ankle, hips, lower back
- Running technique
- Sub-optimal movements patterns
- Inappropriate footwear
These would all need to be assessed and addressed appropriately.
Coming to APC, we will assess all of these potential contributing factors and put you on an individualised strengthening and recovery program to get over your tendon pain.
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