1. DON’T rest.
Tendon injuries can happen because you are OVERloaded or UNDERloaded. Basically tendons don’t like change with an adaptation phase of up to 6 weeks (it takes up to 6 weeks of doing the same thing before they are happy to continue doing that same thing…).
We want to avoid seeing patients in the middle of a tendon pain flare up who cease all activity. This leads to under loading and therefore reducing the tendons capacity to manage load making OVER loading much easier to do.
2. Load the tendon… progressively.
Rehab of a tendon pain is focused on manipulating the load on the tendon. This can be done by altering intensity, volume and/or frequency.
Research suggest we should heavily, but slowly add resistance to a tendon (so it doesn’t have to “spring” back or put up with shock. Eccentric (lengthening strength) is also used as a mainstay in tendon rehab- they key? It must be heavy.
As our tendon starts to heal, and cope with the load do you know what we need to do? Load it more. This way we teach the tendon to cope with more and more…
How do we progressively load the tendon? Just like we unloaded it. Through intensity, volume or frequency.
3. (Some) pain is ok.
3/10 pain (10 being the worst you can imagine) is okay when you are rehabilitating a tendon. That means keep going with your current load. When this increases to a 4 or 5/10 think of this as your warning. Here you should consider reducing your exercises (not stopping) is important.
We teach you how to manage this loading and how to monitor your symptoms. This way you understand the pain and no longer fear it.
4. Be realistic.
Research tells us that a tendon needs a MINIMUM of 12 weeks to “heal”. 12 weeks of consistent loading . Any mishaps or loss of consistency (or silly mistakes…?) this time increases.
Know how long it takes but don’t expect there not to be some twists and turns.
5. Isometrics can be helpful.
BUT proceed with caution. We tend to underload when we use isometrics. They need to be heavy… 80% of what your muscle is capable of.
When to use them? In the early stages of rehab when we are relatively resting or as a pain management tool. Try 3 x 60s holds (or total of 60s holds) with short rest between sets, to get started.
6. Please don’t poke it. Or stretch it. Actually, just leave it alone.
Have a tendon injury or niggle that just won’t go away? We can help.