Patella tendonitis, achilles pain and tennis elbow. If you have had any of these conditions or others like it, you know how frustrating and slow it can be to make them go away.
How do you know you have tendonitis? It will generally follow these characteristics. You can use the point of your finger to identify to sore area and it will feel worse upon first loading and generally feel better once you are “warmed up” after moving for a short period.
Tendonitis is a soft tissue injury, however, its management can be vastly different to other types of injury. This is mostly due to the function of the tendon within a greater system, how it responds to different forces and the tendon’s unique physiology.
Here is the typical experience some one might go through.
Perform X activity that causes pain or an exacerbation.
Feeling sad and sorry for oneself and thinking “I better rest this”
It starts to feel a little better: “Yay!”
“Lets test it out”, Proceed to perform X activity again.
Repeat 1-5.
Because most people’s behaviour follows this type of pattern, a cycle will often form that will never produce the desired result: pain free activity.
BUT IT NEED NOT BE LIKE THIS!
Follow these tips if you wish to recover in the fastest possible way.
1. Rest is important, but it is not the answer!
Resting the area is a good idea temporarily. However, all systems of the human body adapt to the stresses placed upon it. Tendons, due to their physiology and histology, love to transmit force alone a single straight line. Therefore, specific exercises must be performed to work the tendon to allow it to adapt and strengthen.
2. Stretching is important, but it is not the answer either!
Yes, stretching tight muscle groups around the affected area as a way alleviating the strain on the tendon might help a little, but again it will not solve the problem. The primary issue is that the tendon lacks the ability to take any considerable load. As a result, stretching something that should be stronger will most likely be counter productive.
3. Build tendon capacity.
All tissues will have a breaking point. Tendonitis simply occurs when the tendon cannot take any more load and starts to break down. This is where it is essential to perform the correct type of exercises that will strengthen the tendon. Tendons respond very well to isometric (no movement) or eccentric (holding muscular tension while being lengthened) type movements. When performed correctly and in the right doses, this type of exercise builds tendon capacity, which is the ability to perform normal activities and exercise without being aggravated.
4. Know what exacerbates the tendon.
Activities that cause an increase in symptoms must be identified and understood. Get specific with what make the situation worse and write it down. It could be holding a phone in a certain way, running beyond 2 km or any other movement that you experience in day-to-day life. Document these things, write it on a big piece of paper and put it on the fridge so you see it every day. Avoiding aggravating factors in the short term can make a huge difference in the long term.
5. Never massage or mash an achy tendon.
Muscles, facia and trigger points generally respond very well to soft tissue work like massage, self myofacial release or trigger point work. The same is not true for tendons. Tendons are excellent at taking distraction forces (think like pulling 2 ends of string apart) but very poor at taking compressive forces (think like pressing on them). It is likely that massaging or pressing on them is continuing to inflame the tissue and slow the healing process down.
6. Nourish the tendon.
Increasing blood flow is beneficial in the heeling process. Due to the physiology of tendons, they typically have very poor blood supply. Techniques like compression band flossing can be used as a way of encouraging blood flow to the area.
7. Don’t give up on yourself.
Be diligent and committed with your rehabilitation. Understand that tendons can be slow. In just about every client we work with at Empower, those who are dedicated to the process always recover faster and have a better outcome.