Preventing Tendinopathies

Its that time of the year again where we all emerge from hibernation and hit the track ready for summer. But far too often this sudden increase in activity can be more damaging than good, so clever programming and exercise timing can keep you going strong all summer long.

The focus of this article will be on programming essentials to help prevent tendinopathies in the athlete that’s considering adding a little extra to their training.

A recent blog by Jacinda outlined the pathogenesis of tendinopathies and a number of tips on what we can do to combat this issue. You can view the blog here.

This article will be a continuum of Jacida’s 4 Ways to Create Invincible Tendons for Improving your Athletic Performance,  with the focus being on programming essentials to help prevent tendinopathies in the athlete that’s considering adding a little extra to their training.

jacinda-cheong-physio-melbourne

A Brief Overview of Tendinopathies

Tendinopathies are an overuse injury to the tendon. This can happen when loads through the tendon exceeds its ability to repair over a period of time.

Tendons are designed to withstand large amounts of force with some capable of transmitting up to 8 times body weight. But issues arise with sudden changes in volume. Tendons are a creature of habit and are not too fond of dramatic changes in loads.

What happens when we load our tendons? Mechanical loading of tendon tissue results in upregulation of collagen expression and increased synthesis of collagen protein within the tendon.

Magnusson et al (2010) demonstrated that there is an increase in protein synthesis after loading a tendon, however, at the same time there is also degeneration of the tendon. Within 36 hours there is a net loss in collagen within the tendon. At around 36 – 72 hours following load protein synthesis outweighs degeneration resulting in a net gain, as illustrated by Figure 2.

Magnusson et al. (2010)

If inadequate recovery time, and frequent over load of tendons continue then the ability of the tendon to repair is hindered and can result in a tendinopathy which is described as a continuum that can be seen in Figure 3.

 

 

Figure 3

Cook and Purdam (2009)

With this in mind how can we reduce injury rates by tweaking our program?

Gradually increase your load and work capacity. We all tend to get caught up in the hype with a boost of motivation and jump straight into the deep end without adequate preparation. If you’re just starting off or wanting to add extra work to your program, then do so incrementally to allow the body time to adapt to the increased load and avoid injury.

Avoid high loads through similar movements within 36 hours of each other. For example if your workout involves a lot of double unders, then it wouldn’t be wise to go for a run or do box jumps the following day. As described earlier, the tendon response takes over 36 hours to recover from a bout of exercise.

Break your program into upper/lower body or push/pull splits. By doing so you won’t be placing the same loads through specific tendons on consecutive days allowing adequate time for regeneration of the tendon. An example of a program split may look like Monday – Upper body, Tuesday – Lower body, Thursday – Upper body, Saturday – Lower body.

matt-hamilton-ho-physio

 

Key points

Consider all activities inside and outside of the gym

  •     Tendons are metabolically active and respond to both loading and unloading
  •    Tendon loading results in both protein synthesis and degradation of collagen.
  •   Without sufficient rest after exercise, net loss of collagen might occur that leaves the tendon vulnerable to injury
  •   Give at least 36 hours rest between high or explosive loads through the same movement pattern.
  •    Overloading can accelerate the pathogenesis of tendinopathy.
james-brooke-physio

James is a full time Physio at  Evolutio in Melbourne coming from an experienced background in AFL and High level Strength and Conditioning.  James Currently works out of our South Yarra clinic at GW Performance on Tuesday afternoons, Wednesdays and Fridays, Kew at the Workshop 3101 on Mondays, Tuesday mornings and Thursdays. 

Bookings with James for Physio can be made here

  

 

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