With autumn just around the corner, and winter sports on the horizon, a change in activity might be on the cards for some of us. Whether you are increasing your training volume, or changing your daily activities, our tendons are too often the ones to suffer.
If we are under-prepared for the demands of the change in activity, then we are potentially going to overload areas of the body that aren't ready. You may have heard of such tendon injuries as tennis elbow, achilles tendinopathy, jumpers knee and plantar fasciitis (now termed fasciopathy - and although not strictly a tendon the plantar fascia acts like one). While these are commonly known as "overuse" or "repetitive strain" injuries, perhaps we should think of these as tendons that are "under-prepared" injuries. Huh?
A quick note on tendons... they are present throughout the body and are an impressive structure in their ability to store and then release energy efficiently (think kangaroo hind legs). They attach muscle to bone and loading tendons through movement and activity is in fact a great thing, not something to shy away from. This is best done as a gradual process rather than a sharp increase so the tendon can appropriately adapt to the increase in load. And better still, achieve high load when you are young and tendons will develop greater load tolerance for older age....
We risk overuse when there is an increase on the demand of the tendon. If you start with a low capacity to accept that increase in load (think of being immobilised after surgery), then you may be in for a nasty shock and injury pops up. High load on tendons is in fact a good thing when they are up for it. However, this load should occur gradually and with adequate strength of important muscles. If not, injury may develop over days or weeks, leading to pain and loss of function. If the overload continues the tendon will not cope and may become degenerative - a term describing the irreversible change to the tendon structure.
But don't despair. Despite tendons being susceptible to overload, injury and structural change, tendon pain can be successfully managed (even if degenerative!) by working with your physiotherapist. Load management (such as increasing total volume of a particular activity by no more than 10% per week is a popular strategy), combined that with targeted tendon exercises, addressing biomechanical deficits, and importantly how to manage your day to day activity - can lead to a great outcome.
Importantly everybody will experience tendon pain differently - so getting an accurate diagnosis and acting quickly can dramatically improve your chances of staying active and pain free!
At MONTY PHYSIO we love treating sore tendons so get in touch for a thorough assessment.
Pete :)
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