Tendon pain can affect anyone, from the young, high level athlete to the elderly and can present throughout the body but is commonly found in the
- Achilles tendon – back of your heel
- Patella tendon – just below your knee cap
- Hamstring – most commonly just below its insertion into the buttock on your sit bones
- Gluteal tendon – on the outside of your hip
- Rotator cuff (supraspinatous) tendon – shoulder
Tendon pain can appear rapidly after a single bout of exercise/ activity or have a slower onset with more repetitive loads.
So firstly, why do we get tendon pain?
Tendons require continual and progressive load to ensure they are strong and able to cope with the demands placed on it through daily life – whether that be general daily activities such as walking, squatting or to more high impact loads such as jumping, sprinting – more commonly seen in the athletic population.
Tendons strengthen in response to load. A period of decreased loading such as being on holiday, a period of rest may be due to illness or other injury or simply over the Christmas break for athletes can lead tendons weakening and being unaccustomed to previous loads, therefore on return to regular activity the tendon is no longer able to cope with demands it used to leading to tendon pain.
Lets look at footballers for example: during their pre-season training they have worked hard to build aerobic fitness and overall strength, over the Christmas break generally two weeks they decrease their training load and on return to training go back in full intensity. Over the break due to decreased activity the tendons are no longer able to cope with the high impact load resulting in tendon pain – most commonly, in their case, Achilles or hamstring.
In the older population the tendon can be degenerative and sometimes pain free but an acute flare up may occur due to an unaccustomed load.
It is important to remember that whilst you have pain in the tendon
the source of the problem may be contributed to by a series of other factors.
To name a few…
- Muscle weakness
- Decreased muscle activation
- Inappropriate load management, change in activity
- Systemic factors
How can you tell if it is your tendon that is sore?
- Pain is very local – often you can pin-point it with one finger!
- Your pain is aggravated by increased load on tendon
- e.g. for Achillies: calf raise, jump, hop
- Recent changes in training, activity, footwear, illness
- Night pain
- Increased pain in area the following morning post exercise
So what can be done?… PLENTY
Tendons are very smart and can easily grow new healthy, strong tissue, however they NEED load (exercise). There is no reason you should not be able to get back your full healthy and functioning self!
Remember tendon pain does not improve with rest, it is important to MODIFY your load not stop it completely and in terms of the angry tendon PAIN does not always equal damage or injury
In general terms there are many things, which can be done, however below are a few options to try at home
- Reduce pain:
- Modify your load or training but don’t stop all together, it is okay to experience a mild level of pain during exercise and should settle quickly after
- Using exercise, holding a stable position under load for about 45 seconds – this can drastically improve your pain for several hours and is very helpful throughout the day or good strategy to use for athletes to use as warm up prior to game.
- For example, in the painful Achilles Tendon holding a calf raise at mid-height
- Gentle stretching of surrounding areas, not then tendon itself
- Massage surrounding areas
2. Strengthen – as pain settles
- Gradual slow progression in heavy weighted exercises to strengthen area and those surrounding
- Gradually increase speed and add impact into exercises
Working closely with your physiotherapist we can help develop an exercise program individualised to your needs and goals, facilitate your recovery and get you back to YOU – pain free, strong and happy!!
Megan has great experience of looking after tendon injuries, and will make sure you get on the right track fast! To book an appointment with Megan click here