Injury Rehab Progression - Tendon Healing
WHY ISN'T MY TENDON HEALING?
This week we talk about tendons. Tendonitis can be a frustrating injury that can linger long past its welcome (not that it was welcome in the first place). Tendonitis is the term used to describe the acute inflammation of the tendon. However, often by the time you seek treatment, the tendon has taken on a more chronic state of inflammation known as tendinosis.
Think of your tendon like a demolition site. After the initial acute injury, there is a team that comes in to secure the site and clean it up. The team is the inflammation and increased blood flow that is carrying the tools necessary to start the healing process (the cells and chemicals involved in healing). The pain is the security system that says, "hey, stay off this for a little bit!"
After this team secures the area and cleans it up, we still need the repair crew to come in. This is the crew that is responsible for rebuilding.
This is where tendons start to have issues. After a few days off, the area might feel better, the pain has decreased and the swelling is down. However, the site is not repaired or rebuilt. In fact, sometimes the clean up crew gets stuck and we enter into a situation of "chronic inflammation" that many of you have heard of. So, what do we need to do?
We need to get that clean up crew to leave so the repair crew can begin their job. There are several steps that we can take to make that happen:
THE MOST IMPORTANT: Follow the rehab progression that we will discuss in the coming weeks: Mobility, Movement Pattern, Strength, and Load Management
Get mobility where you need it (tendons do not do well with excessive stretching, it's often something else that needs the mobility, ie. the joint)
Reinforce the movement gained by using it
Strengthen the tissue (isometrics and eccentrics!)
Load the tissue systematically with increased resistance, plyometrics, and return to sports.
SOME OTHER THINGS THAT HELP:
Maintaining some activity (i.e. still running but maybe decreasing load or intensity)