Before we know what to do for tendon strains, we need to understand WHY they happen.
Tendons are the end points of muscles that attach muscles to bones. They are like stiffer elastic bands, possessing the ability to stretch and store/release energy.
As they give way, or go under slight stretch when loaded, tendons have the ability to redistribute forces to surrounding connective tissues, including bones, to store energy that can be used to propel you in the opposite direction.
You can think of it as pulling a slingshot back. The more you can pull it back; the band lengthens and has more recoil as the energy is dispersed amongst the entire implement.
When you let it go, the projectile flies at a high rate, as opposed to a smaller pull back, releasing less energy. The projectile weighs the same, but the ability to absorb the energy is not the same.
Due to their attachment, muscles can have an influence on the tendon and stretch the tendon slightly to create more stiffness and prepare the tendon for absorbing loads.
This pre-stretch phase created by the muscles allows you to jump higher or have more “bounce” in your activity as you can distribute forces much faster and the tendon does not have to spend as much time to give way in order to disperse everything. (We are talking a matter of milliseconds here, but it still makes difference).
If you don’t have this pre-stretch, the muscle may be in a position of disadvantage to work harder, and the tendon may have to give way too much too quickly, leading to a loss in energy and unneeded stress to the tendon itself.
In this instance, the band is stretched too fast or inefficiently, causing it to snap, just as if you pulled a slingshot too fast backwards too far. The band would snap and then you are left with no projectile component.
If you are having tendon strains, then you need to first learn how to change the movement patterns that are overloading the area, and then learn how to slowly load the tendon to create the pre-stretch components from the muscle.
This would be in the form of a lighter isometric that puts the muscle in its midpoint of length, with a sustained contraction. Remember this is light, so nothing greater than 50-60% maximal force at the absolute most.
As this gets established, the tendon still needs to learn how to be loaded at faster rates, in a safe, progressive manner, in order to learn how to absorb higher forces to improve overall performance in sport.
Stay tuned, as next week we will talk more about how to progress tendon strains intelligently and implement them in a regular training program.
Dr. Peter Dionisopoulos is the owner and founder of Dynamic Performance & Rehab. He has a Doctorate in Physical Therapy and enjoys to help active adults maintain their lifestyle and provide natural solutions to their pain.
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