Tendinopathy: Heal and Strengthen with Proper Exercise and Loading

What is Tendinopathy?

Tendinopathy refers to chronic pain, dysfunction, and structural changes in a tendon, often caused by overuse, disuse, or improper loading. Unlike acute tendon injuries, tendinopathy results from repetitive stress that overwhelms the tendon’s ability to repair itself. It commonly affects active individuals and athletes but can also occur in sedentary populations due to disuse atrophy or sudden increases in activity (Abat et al., 2018).

Why Does It Happen?

Tendinopathy arises due to several key factors:

  1. Overuse and Repetitive Stress:

    • Excessive or poorly managed loading leads to microtrauma in the tendon, which, if not allowed to heal, results in chronic degeneration (Docking et al., 2015).

  2. Poor Biomechanics and Weak Supporting Muscles:

    • Imbalances or weaknesses in muscles around the joint increase strain on the tendon (Malliaras et al., 2013).

  3. Insufficient Recovery Time:

    • Tendons require adequate rest between loading cycles for collagen synthesis and repair. Overloading without rest can disrupt the healing process (Cook & Purdam, 2009).

  4. Age-Related Changes:

    • With aging, tendons lose elasticity and become more prone to injury due to reduced collagen production and vascularity (Rees et al., 2014).

  5. Systemic Risk Factors:

    • Conditions like diabetes, obesity, and metabolic syndrome impair tendon healing and increase the likelihood of tendinopathy (Abat et al., 2018).

Common Tendinopathies

Tendinopathies most frequently occur in areas subject to repetitive motion or weight-bearing stress. Common examples include:

  1. Achilles Tendinopathy:
    Pain and stiffness in the back of the ankle, often seen in runners and active individuals.

  2. Patellar Tendinopathy ("Jumper’s Knee"):
    Pain at the base of the kneecap, commonly affecting basketball and volleyball players.

  3. Rotator Cuff Tendinopathy:
    Pain and weakness in the shoulder, often called shoulder impingement syndrome.

  4. Tennis Elbow (Lateral Epicondylitis):
    Pain on the outside of the elbow due to repetitive gripping or wrist extension.

  5. Golfer’s Elbow (Medial Epicondylitis):
    Pain on the inside of the elbow, often caused by repetitive wrist flexion or forearm pronation.

  6. Gluteal Tendinopathy:
    Pain on the outside of the hip, frequently seen in middle-aged women and runners.

Exercise: The Cornerstone of Tendinopathy Management

Proper exercise and tendon loading are essential for managing tendinopathy. Research highlights several evidence-based strategies:

  1. Isometric Exercises:

    • Alleviate pain and maintain tendon load capacity during the early stages of rehabilitation (Rio et al., 2015).

  2. Eccentric Loading:

    • Eccentric exercises promote collagen synthesis and tendon remodeling, effectively reversing degeneration in chronic tendinopathy (Malliaras et al., 2013).

  3. Progressive Tendon Loading:

    • Gradual increases in load improve tendon strength and capacity, reducing the risk of reinjury. This should include both concentric and eccentric exercises (Cook & Purdam, 2009).

  4. Dynamic and Plyometric Training:

    • Advanced stages of rehabilitation incorporate plyometrics to restore the tendon’s ability to absorb and release energy during high-impact activities (Docking et al., 2015).

  5. Flexibility and Biomechanics:

    • Improving physical capacities to tolerate different stresses, in different positions, aid in improving the tendons ability adapt and deal with these forces.

Why Act Now?

Ignoring tendinopathy can lead to worsening pain, chronic dysfunction, and reduced ability to perform daily activities. A structured exercise program not only relieves pain but restores tendon health, function, and resilience for long-term recovery.

Our Concierge Services: Personalized Tendon Care

At Higher Performance Metrics, we specialize in designing exercise programs for individuals with a history of tendon issue with customized exercise programs that focus on:

  • Comprehensive assessments to identify physical deficits.

  • Progressive loading plans tailored to your current tolerance.

  • Expert guidance to ensure safe and effective training progression.

Heal and Strengthen Today

Don’t let tendinopathy limit your life. Take the first step toward pain-free movement with our evidence-based concierge programs designed to restore tendon health and function.

Click link to schedule your consultation. Visit our contact page for any questions.

References

  1. Abat, F., Alfredson, H., Cucchiarini, M., Madry, H., Sharma, P., & Maffulli, N. (2018). Tendinopathy: Clinical practice, tendon biology, and basic science update. Nature Reviews Rheumatology, 14(10), 575-592. Link

  2. Cook, J. L., & Purdam, C. R. (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6), 409-416. Link

  3. Docking, S. I., & Cook, J. L. (2015). Tendinopathy: Is pathology a continuum? Sports Medicine, 45(1), 23-30. Link

  4. Malliaras, P., Barton, C. J., Reeves, N. D., & Langberg, H. (2013). Achilles and patellar tendinopathy loading programmes. Sports Medicine, 43(4), 267-286. Link

  5. Rees, J. D., Stride, M., & Scott, A. (2014). Tendons: Time to revisit inflammation. British Journal of Sports Medicine, 48(21), 1553-1557. Link

  6. Rio, E., Kidgell, D., Purdam, C., Gaida, J., Moseley, G. L., Pearce, A. J., & Cook, J. (2015). Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. British Journal of Sports Medicine, 49(19), 1277-1283. Link

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