08 Aug 5 reasons why your tendon rehab is failing
A running-related tendinopathy is very common
It can also be one of the most debilitating. I see tonnes of runners trying to manage tendon issues for months or years! And as I delve into their rehab history I often come across several common mistakes. I will mention some of the most common below.
- You are resting it too much: It is human instinct to rest an injury. However, tendons respond very well, and recover quicker, to the correct amount of load. Most commonly, your tendon has flared up from a spike in your running, this irritated state temporarily ‘weakens’ the tendon structure. Trying to solve the problem with complete rest continues to weaken the capacity of your tendon, further contributing to the problem. A more proactive step would be to start loading the tendon with it’s new adaptation zone. A process made simpler with the guidance of a health professional.
- You are not correctly interpreting symptoms: Mild symptoms can occur at the start of a run but quickly disappear. Common sense would interpret this as permission to continue running. Do not be fooled! Symptoms can often return (with interest) later in the day and most commonly,the following morning. If you do wake up with a stiff and sore tendon, interpret this as a warning sign that you have overloaded your tendon over the past 24 hours.
- You haven’t modified daily aggravating factors: Once irritated, daily tasks that were once insignificant have become a main contributor for tendon flare ups. An example would be sitting for hamstring tendons or standing for plantar fasciitis. These tasks and postures need to be modified to reduce likelihood of flare ups. Sitting modifications, taping, shoe prescription and lifting strategies are a short list of possibilities. Professional guidance is recommended.
- Your strength rehab isn’t progressive enough: Isometrics (load and hold) exercises are a fantastic first step. But depending on your stage of rehab, will not be enough to restore all capacity, especially for runners! All the evidence points to progressive, slow, heavy loading under dosages that are tolerated by the tendon. Once you have built a suitable base, then progress to ‘store & release’ speed and plyometric exercises. If this puzzle piece is missed, you will experience another tendon flare-up once running commences.
- You are relying too much on passive treatment: Massage, dry needling, trigger point release, these are all suitable for an athlete in the first few days of a flare-up. But these types of techniques do not restore a tendon. Only a well structured strengthening rehab will achieve long-term results and casat as early as day 1.
Reflect on the above areas to see if your rehab has any missing pieces. Another mistake is going too long without seeking professional help. If you are not sure of your next steps please consult a health professional. Thanks for reading.