Tendon Injuries & StrainsWhy Resting Injured Tendons is No Longer Preferred
Tendon Injuries & StrainsWhy Resting Injured Tendons is No Longer Preferred
Posted in Physiotherapy by Jason Wright on April 25, 2020.
Gone is the phenomenon “if it hurts don’t do it”. Resting injured tendons is not the way to overcome the injury. The pain response will diminish over time when ceasing the aggravating activity/position. However, the tendon is still injured! The key is building progressive adaptations to meet the demand of load placed on that tendon.
Progressive adaptations will help you with prevention and management of most lower limb tendinopathy’s including plantar fascia, achilles, hamstring, patella and gluteal tendinopathy’s.
A tendon reaction will always be due to a sudden overload. Every tendon has a certain load capacity and if you train just below this capacity in time it will adapt and get stronger, increasing its capacity. If there is a spike in load which exceeds a tendon’s load capacity it will signal pain. These spikes in load can come in several forms including incline, distance, intensity, change in shoe type or change in surface. A sudden increase can also be in one training session or over the course of a week. This is crucial knowledge for prevention.
A spike in load causing tendon pain, results in an overall drop in the tendons capacity. However, resting this tendon will further the regression of the tendon capacity. What does this mean? If we continue on this rest and load cycle, the tendon will continue to lower it’s capacity and we will be left with a load intolerant structure that once could run for 20 minute without pain, causing pain upon walking up a hill for example 4 months into this downward spiral.
Physiotherapy guided loading and strengthening below this tendons capacity will allow the adaptations to be made again. Therefore stopping the downward spiral and getting you back to pain free activity.
Six months of tendon pain will result in irreversible changes in tendon structure. However have no fear, this doesn’t mean we can’t work back to pain-free and fully functioning, however, progress will be slower and with increased likelihood of re-injury. The sooner tendon pain is addressed the better.
As runners, we cannot just try and run fast or run far. We also need to run smart in order to get the best results.
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