The most important step in managing any tendinopathy injury is load modification.
Patients will commonly present to me with a mechanical tendinopathy due to an increase in the load or stress placed on the tendon.
Some examples of why there may be more load through a tendon are (with the tendon it is most likely to impact):
- Increased body weight (think lower limb tendons)
- Increased distance or pace of running (again, think lower limb tendons)
- Increased jumping in sports such as basketball (once again, lower limb tendon)
- Increased side stepping/kicking in soccer (adductor tendon in the groin)
- Increased activities which require gripping of the hand or repeated wrist movements (tendons around the upper forearm/elbow)
As mentioned in last week's post, part one, tendinopathies can also manifest from reduced load through the tendon.
Tendons require a proportion of load to keep them healthy and functioning well. Prolonged rest can lead to changes that cause the tendon itself increased stress when “everyday” loading is placed through them again.
As mentioned, load management is the key to health tendons, and luckily we have devices such as bracing or foot orthoses to help reduce the load through the painful tendon.
Above all, education underpins the bulk of physiotherapy management for tendinopathies. It is vital that patients understand the importance of activity modification to reduce load through a painful tendon.
It is not uncommon for me to emphasise this over and over again as it would be very difficult (almost impossible) for a patient to get better without adhering to the advice.
For many patients, coming to terms with this can be extremely challenging. It is often when patients are just in the peak of their running training, or the beginning of the footy season when they are raring to go!
Do you have any tips of how to best manage this challenging part of tendon rehab?
You can check out the rest of the articles on tendinopathies here: