It is usually the most troubling complaint for a patient and pain in the tendon can lead to reduced activity in the muscle it’s attached to. Your first aim with managing tendinopathy is often to reduce pain. (2013) “Each component of the rehabilitation programme, in particular loading, must be manipulated in relation to the nature, speed and magnitude of the forces applied to the muscle/tendon/bone unit in order to achieve the goals of the particular management phase without causing an exacerbation of the pathological state or pain.” Tendon and muscle function together as a musculotendinous unit – we need to consider this in rehab, not just the tendon. A key goal in tendinopathy rehab is improving the capacity of the tendon and muscle to manage load. So, while we can make some recommendations, there is still some way to go before we have conclusive evidence on tendinopathy rehab.Īs there are many treatment options for tendinopathy and many factors to consider, keep your main treatment goal in mind. They also found that around 45% of patients didn’t improve significantly with exercise programmes. Just 2 studies were deemed ‘high quality’, only 2 described adequate blinding and the majority did not use a validated outcome measure. (2013) reviewed the literature recently on loading programmes for Achilles and patellar tendinopathy (2 of the most common) and found a number of methodological flaws. By this I mean that we have surprisingly few high quality studies proving clinically significant improvement from treatment. There appears to be a bountiful supply of theoretical research but little in terms of high quality clinical trials. Our management of this condition is very different now than 10 years ago and 10 years from now will likely see different treatments again. There is no recipe for tendon rehab! I have included ‘in a nutshell’ summaries at the end of each section and a ‘key point review’ at the end if you don’t want to read all the technical stuff!īefore tackling this piece on rehab I recommend you read our article on tendinopathy staging and compression as this is the foundation for much of the work here…ĭespite recent advances in research tendinopathy rehab remains in its infancy.
If you have a tendinopathy I highly recommend seeing a qualified Physio/ health professional for advice specific to your case. Runners reading this… please beware this is a complex condition and therefore a fairly technical piece. It’s based on an excellent talk by Toby Smith from UK Athletics and a collection of recent research. This piece is part 1 of an overview of tendon rehab. Funny what an injury does isn’t it? A few months ago I developed a hamstring tendinopathy and since then I’ve become a total tendon geek! The upside of all this is I have new knowledge that can help others manage troublesome tendons! Even injuries can lead to positive things if you can learn from them.