4 Do's and 4 "donuts" in treating a painful tendon.

Updated: Jan 29

Rule #1

Do not ignore your pain.

Pain is telling you that you need to change. It's an indication that the tendon is not fit enough to cope with your current activity .

Rule #2.

Get the tendon properly assessed.

You need a good diagnosis to form a great plan of action, get the best starting point and a progressive plan of action. Otherwise it can be  a bit hit and hope.

Rule #3.

Do Not completely rest, Use it or Lose It.

If we rest the tendon and the muscle attached to it they will get weaker and less resilient resulting more of the same problem.

Rule #4.

Deload the tendon so you can reload it.

Most tendon issues are due to a lack of tissue fitness. We need to get them stronger to tolerate and absorb force.

In the early stages its a case of taking 1 step back to move 3 steps forwards.

This can be as simple as

  • identifying and stopping aggravating postures or activities.

  • reducing training volume.

  • adapting exercises to suit your symptoms.

Once the pain has settled then we can really get down to the business of getting a healthy tendon back.

Rule #5.

Don't rely solely on passive therapies, you must play an active role.

On their own the likes of TENs machines, ultrasound etc are effectively useless. At best they will offer temporary relief of symptoms but won't improve the strength of the tissue.

Shockwave can be helpful as an adjunct to help reduce pain and "kick start the repair process, but is most effective in conjunction with a strength based exercise protocol.

Rule #6.

Ain't nothing wrong with getting strong.

The evidence suggests that the best way to strengthen a tendon is to work at 70% 1RM.

It is best to do one or two days on followed by a day of rest when loading the tendon to allow it to recover, adapt and get stronger.

A mix of static, heavy load and eccentric exercises work best, and they need to be made progressively harder and more specific every 4 weeks.

Rule # 7.

Do Not worry about tearing or rupturing the tendon.

Pain is poorly correlate with tendon ruptures. In fact most individuals who rupture a tendon do not report having any pain.

Rule #8.

Be patient and be persistent.

As a rule of thumb it takes about 3 months to increase the strength of a healthy tendon. Your symptoms will improve well before this in most cases, but you have to work over a long period of time to get it back to its optimal state.

Sneaky Rule #9

How to feed a tendon.

Nourish the tendon by using a collagen based supplement and vitamin C to help with building stronger tendons See more here

If you have any tendon related problems you can book in here to see one of very experienced clinicians


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