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.

References
- 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
 

A Physiobikefit involves a cycling physiotherapist assessing your body, your bike, your cycling technique. Physiobikefit can help you move well and ride better.
Scott Smith is a very keen cyclist who has been riding for a number of years. He regularly  competes in mountain biking races but trains as much on the road bike.
He recently came third in the teams section at the Epic mountain bike event held each year at Hiddenvale. This race has over 500 entrants.
We have the clinical skills and bike-fit expertise to evaluate why you might be experiencing

• Lower back & neck pain
• Mid Back pain
• Knee and sit bone pain
• Hand tingling and numbness
• Inefficient pedaling
• Everyone's body moves differently. Physiotherapist are specialists in assessing movement. This will involve a specific bike screening procedure looking at exactly how your body moves, muscle strength of specific cycling muscles and the joint range of motion required to be efficient on a bike.

A bike fit will also be performed to look at how your bike is set for you.

The Physiobikefit involves:

• Taking a detailed history of any injuries / cycling history / possible reasons why injury may have occurred
• Specific measurements of lower limb range of motion / strength and  muscle activation
• Bike dimensions assessment and how you sit and function on the bike
• Video assessment of you on the bike
• Emailed report of how to improve performance/ reduce pain and dysfunction

FAQ

• Why a Physiobikefit- It is paramount to assess the cyclist's physical capability as well as the cyclist on the bike. A bike fit that does not have all this information is not able to  make accurate decisions.
• What should I bring? Bring your bike, cycling shoes and shorts/knicks. The assessment is done with no top off and a few texta marks. We will change over your rear skewer if required or you can bring your own for attachment to a MagTrainer.
• How long will it take? Your appointment is for 1 hour, with reports emailed to you within 24 hours.
• What will occur during the session? We will initially talk about any soreness, injury or concerns, as well as your cycling history, training and your bike. We will then assess and measure your body and your bike, and video you on the bike under various conditions. We will then analyze the findings and together plan for bike changes, exercises, treatment or cycling technique correction as required to optimize your cycling performance and experience.