Load is Good for Tendons!

When you get tendon pain then tendency is to rest. Exercise makes the tendons hurt, so resting will make them better, right?

Well, not really.

Resting will almost certainly improve your pain, but there is more to tendon pain than simply the pain.

Pain in a tendon, for example the Achilles tendon which connects the calf muscles to the heel, or the patellar tendon which connects the quadriceps to the tibia, comes about as part of a process where the tendon is placed under more cumulative load than what it can deal with. Being living tissue, the tendon has the capacity to remodel to be able to accommodate greater loads. However tendons have a poor blood supply, making them less able to remodel vs muscles for example.

The risk factors for developing tendon pain involve two things

• Increased load on the tendon – for example increasing your training load or gaining weight
• Reduced capacity of the tendon to remodel – for example increasing in age or having diabetes

When you rest from the aggravating activity, and therefore place less load on the tendon, the pain should improve, but the tendon will not become more able to deal with load (in fact it will likely become less able to deal with load). This means that when you return to your normal training load the tendon will likely become painful.

The best management strategy for dealing with tendon pain is to control the amount of load the tendon is exposed to, and to graduate this load in a controlled manner to facilitate the tendon to improve it’s ability to accommodate load. This includes controlling the training load (for example reducing running distance, avoiding hills, reducing the number of training sessions per week etc), as well as an eccentric strengthening program with increasing reps, sets and/or resistance.

Some times very sore, sensitive tendons need rest from all aggravating activity for a short period of time in order to settle down enough to be able to perform the rehab exercises. But for the most part pushing through some mild to moderate increases in pain is beneficial in helping the tendon to recover in the long run. Applying ice for 15 minutes following aggravating activity can be helpful to settle tendon pain during your rehab program.

Recovering from tendon pain can be a long, frustrating process, while sometimes it can be quite quick and straightforward. It’s less likely to be a long recovery if you start addressing your tendon pain early!

If you’re experiencing tendon pain see our physiotherapist in Aubin Grove today!