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Load before you Leap

Posted by Terry Castelli on 13 January 2017

2017 has started, motivation is high, the running shoes have been dusted off, and then you develop ankle, knee, hip or hamstring pain after the second or third run. You aren't the only one! This time of year it is a common to see patients walk through the clinic doors with tendon pain because they went to hard to soon.

Tendon injuries can be acute or chronic and is a common condition in sports people, recreational athletes and weekend warriors. More often than not patients have a sudden increase in the intensity, frequency and duration of activity and only allow a small amount of time for recovery. Studies have shown that people who have less than 2 rest days/week, have a 5 x increased risk of overuse injury and unfortunately this risk increases with age. Obviously, elite athletes require and have a greater tissue capacity than recreational players and weekend warriors.

From a physiotherapist point of view, we explain to the patients they have exceeded their tissues capacity, which resulted in cellular changes, and eventually a pain response. Think of two pieces of rope, one thin (unconditioned) and one thick (conditioned) that are separately suspending 100kg each. The thin rope maybe able to hold the weight, but most likely it will stretch, and rarely will it snap. But the thick rope could hold onto the 100kg all day. We view tendons like these ropes, people who are unconditioned (weekend warriors) have not conditioned their "ropes" to be able to handle the same amount of load of people who have conditioned "ropes" (athletes).

The aim of rehabilitation is to gradually increase the tendons ability to tolerate higher loads. By increasing the load tolerance slowly you will increase your capacity to sustain the increasing demands you place through the tendons while exercising. There are studies that support rehabilitation that targets strength and limb biomechanics will produce promising clinical outcomes in the long term. 

If you, or someone you know, are experiencing tendon pain after starting or increasing exercise book an appointment with one of our physiotherapists at Albany Creek Physiotherapy. We can help you develop the appropriate rehabilitation program to keep you moving, reduce your discomfort and return to sport/exercise pain free quickly.

- Ristolainen. L, et al, 2014. Training-related risk factors in the etiology of overuse injuries in endurance sports, J Sports Med Phys Fitness; 54(1):78-87

- Rio. E, et al, 2015. Tendon neuroplastic training: changing the way we think about tendon rehabilitation" a narrative review, Br J Sports Med;0:1-8

- Malliaras, P., Understanding mechanisms to improve exercise interventions in tendinopathy, Physical Therapy in Sports (2017), doi:10.1016/j/ptsp.2016.12.006

- Cook. J, Docking. S, 2015. "Rehabilitation will increase the 'capacity' of your ...insert musculoskeletal tissue here..." Defining 'tissue capacity': a core concept for clinicians, Br J Sports Med, doi10.1136/bjsports-2015-094849


Author:Terry Castelli
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