Painful Tendons Need Load, Not Rest
One of the most common overuse problems is a tendon injury. This problem goes by many names such as tendonitis, tendinopathy, or tendinosis.
These names all have slightly different meanings, but they all boil down to a common factor: the tendon was put under more stress than it could tolerate and has become painful.
It’s all about stress
Our bodies can only withstand physical stress up to a certain point. This is why you can get sore with weight lifting or trying a new activity.
Sometimes tendons are injured by a large stress applied over a short period of time. This can happen when throwing a football without warming up or jumping off a high surface.
Other times, the tendon is stressed over a longer period of time. For example, if a runner increases their mileage too quickly over the course of a few weeks, their Achilles tendon may start to be painful because it couldn’t recover fast enough.
So, how do we help tendons recover?
Tendons don’t have great blood flow, which limits their ability to heal. Compared to a muscle injury, tendons take an extra 1-2 months to fully recover.
Tendon injuries tend to come back if not treated properly. We see many patients in the clinic who have had recurring tendon injuries because they were not treated properly.
Rest and ice won’t heal a tendon
Let’s say a runner injures their Achilles tendon. Here’s how the process normally goes without proper treatment:
The runner tries to keep running, but the pain gets worse.
The runner tries resting and icing for 1-2 weeks.
Pain starts to go away, so they start running again.
After a few runs, the pain is back.
Does this sound familiar? I see this issue all the time in the clinic. Rest is only part of the equation. Carefully applied stress is the other important piece.
If a runner stops running to let their injury heal, it DOES help the injury to calm down. But during the rest break, the tendon and surrounding muscles become weaker. Now, when the runner tries to return to running, their tendon can’t handle this new stress and starts becoming painful again.
Carefully applied stress is crucial
While the runner is taking some time away from running, we need to carefully stress their tendon. Progressive loading is a hallmark of physical therapy treatments. In the clinic, we do this by finding exercises the patient can complete with minimal pain, and slowly making them more difficult with time.
As the runner gets stronger, we can progress their program—causing the tendon to adapt and become stronger. Now when the runner goes to start running again, we’ve set them up for success. The tendon can withstand more stress than it could when they started resting.
Physical therapists guide this process
In the clinic, we work to find the right amount of stress. We guide you through the journey, giving you specific exercises and insight into your problem.
We help you make your program more difficult, manage setbacks, and set long-term goals for your success. If you’re dealing with a nagging tendon injury, we can help you.
Head to our physical therapy site and book a free 15-minute phone call to see if we’re a good fit.
