The tendons are very strong tissues and their role is to absorb the energy that is caused both by the activities of everyday life such as walking, but especially by sports activities such as running and jumping.
There are many factors responsible for tendinopathy, including idiosyncratic, genetic, metabolic and immunobiological factors. However, the factor that appears to be the predominant is the sudden increase in tendon loads, such as when an athlete suddenly increases his training volume, without giving the tissue the appropriate time for a full recovery.
What we need to know is that tendinopathy is a chronic condition and is not an inflammation in the classical sense. The main symptom is pain, which can be relieved temporarily with anti-inflammatory drugs, however, medication cannot cure the condition.
Current research and our experience have shown that exercise is the best way to deal with tendinopathy. 20 years ago, eccentric exercises had been proposed as the best type of exercise to treat tendinopathy. However, as our experience and our knowledge deepen, the training programs gain greater specialization and variety.
But what are the key points of a successful recovery program?
- The exercise program can begin even at the stage where the pain is very intense with isometric exercises. It has been found that isometric exercise helps both the mild activation of the muscle and the central nervous system, causing a reduction in the sensation of pain and improving the functional capacity of the individual.
- When the pain reduces, then a Heavy Slow Resistance Training exercise program begins
- The factor determining how to progressively increase the load on the tendon is pain. It has been found that exercises should only cause a discomfort (3/10 on a pain scale from 1-10), but not a further increase. Therefore, little pain is not detrimental to tendinopathy, as long as the symptoms do not worsen the following morning.
- When the symptoms reduce significantly, a plyometric exercise program begins (e.g. jumping exercises). The aim is to enable the tendon to adapt to its normal function, which is the storage and release of energy.
- It should be emphasized that the exercise program is strictly specific to each individual and that the rehabilitation program will take 2-3 months, as tendons by their nature are slow to adaptation and remodelling.
Throughout the treatment, the patient has continuous communication with the therapist to report the symptom behavior and must visit the Physiotherapy Center once every 2 weeks for reassessment and advancing the exercise program.