Tendon problems account for a large proportion of patients visiting their GP for advice and treatment. They are also one of those tricky conditions that don’t often do well with surgery. After seeing a consultant, it may therefore be that they send you away to persist with conservative management strategies rather than surgery. An Achilles tendinopathy might cause you discomfort for years and a ‘tennis elbow’ may also cause all sorts of problems when you grip or lift.
1. Build Up Gradually
Tendons are not very well vascularised, that is, they have a poor blood supply and so don’t respond to change or overload well. Their job is to take loads and convert it into useful movement for us, but in doing so they can sometimes get overloaded. A good example is the patella tendon in the knee. It is used to taking loads as we walk up and down stairs, as we run, and as we jump or hop. However, it isn’t very good at getting used to a sudden increase in hopping, such as when taking up a new sport or a new job where you have to bend and squat a lot. The tendon takes a long time to get used to the new stresses it is under and unless we give it time to change, the results can be painful. Tendons are able to change and eventually withstand the new pressures they are under, but the changes in your habits need to be steady. Changing steadily can be particularly difficult when you have a break, such as the Christmas holidays, or illness for a few weeks. By jumping straight back in to the previous regime of activity you were able to do before the gap, it may result in tendon problems. Tendons always respond better to a gradual build up.
2. Rest and Listen!
Tendons also need a few days off following increased activity. The slow blood flow within tendons means that change happens slowly, and so working out hard two or three days in a row can be too much for them. Tendons need around 24 – 48 hours to allow recovery to occur. This takes some scheduling of your exercise plan and you’ll also need to take into account the hidden exercise you might not have considered such as a long walk to the shops, gym work or game play at football. The added bonus of leaving this time between exercise sessions is that it allows you to see if you have over exerted yourself. Seeing how you feel the day after exercise, or any type of activity will allow you to notice if things are stiffer and more uncomfortable the following day. If this is the case, then you know you have overdone your training and that you should drop the amount you do next time. This is more important than how you feel during the actual activity. It may be that you are sore during jumping drills in a netball training session, but really it’s the large amount of latent pain the next morning and hobbling out of bed not able to walk properly, which tells you have done too much. Always listen to your body.
3. Work with a Physio
Setting the right level, progressing at the right time and finding your limits are tricky to set on your own. Seeing a physiotherapist with knowledge in this area is the ideal way to progress from where you are. This is particularly true when it comes to looking at the wider picture emerging recently, which suggests a more ‘central component’ to tendon issues. By this we mean the involvement of brain processing on tendon pain, so aside from treating locally to the actual tendon, we should also be addressing the spinal cord, nerves and brain processing which occurs after every injury.
Are you suffering from tendon pain? One of our highly specialised physios is able to see you for an initial appointment at home or work. Contact us today to arrange an appointment convenient to you.
Post by Leanne Plenge, Physiotherapist and Bristol Manager.