Tendons Love Load

Once we are fairly certain we are dealing with a TENDON disorder… Where do we go from here? 

The #1 rule to remember is that TENDONS LOVE LOAD. Absolute rest is rarely ever indicated for promoting tendon recovery. However, that does not mean that pushing through your normal training is magically going to heal it.

Think of load on the tenon as a bell curve. Not enough input results in no change in the tensile strength of that structure. Too much load results in deformation of the soft tissue, and injury/pain. In rehab, our goal is to find that “sweet spot” in the center where we are loading a tissue enough to create change, but not so much that we overwhelm it, especially during recovery from an injury. 

General Rules:

  1. You are not ready to start running again if you cannot get through your daily activities without significant pain/modification. 
    1. This does not mean do nothing – focus on what you CAN do while avoiding more aggravating activities. Walking, biking or other cross training, strength training can all be fair game.
  2. Look back at what your training and life stressors looked like leading up to this injury.
    1. Increased mileage? Really challenging hike? Changing (or not changing) shoes? Take a moment to reflect on what got you into this situation.
  3. “Discomfort” with activity is ok! 
    1. Don’t shy away from soreness with activity. We have to load the tissue in order to create change. Sharp pain that is worsening and causing you to modify how you move = stop or modify activity. Soreness that is staying about the same and you are able to work through without modifying is completely appropriate. In general that soreness should resolve within 6-12 hours of exercise. 

What have I been doing this week to load my foot:

  1. Single Leg Heel Raises. ‘Cause baby cows need the love.
  2. Creep/Carry: Slow, controlled, keeping the heels off the floor.
  3. Runner balance: move slowly, barely brushing the back foot to the floor. All of your weight should stay balanced through the standing leg. 30-45sec bouts. (video available on Instagram!)
  4. RDL w/ arch lift: Pull the band up while maintaining pressure into the ball of your foot

These are all modifiable and not appropriate for everyone/every situation. Just what is currently working for me. Questions? Let’s chat!