Tendon pain is due to tendon weakness compared with the demands of the activity and sometimes large spikes in pressure, such as running 5 times a week when you usually run twice.
Pain is usually worse when you wake up in the morning or when you begin exercise and then settles, as if it needs to be ‘warmed up’, and then gets worse again once you’ve given it too much activity beyond what it can handle.
We hear it all the time when it comes to tendon pain… “I’ve been stretching it but I still have the pain”.
So let’s get a little scientific about it - Why doesn’t it help?
In normal tendons, the cells are organised nicely like a brick wall. When tendons are “overloaded” and not strong enough for what we demand from them, the tendon cells produce too many proteins called proteoglycans. Over time, the increase in these proteins disrupts the structure of the tendon and the cells become disorganised and no longer have a nice brick wall structure because there are too many proteins between the cells. The proteins swell up with water during further exercise, which disrupts the tendon structure even more and the result is that the tendon does not function well.
Here’s a picture that shows what a normal tendon and a painful tendon look like under a microscope (from sciencedirect.com):
Picture in your head a brick wall but with the bricks further apart from each other - it’s not as strong anymore. When a painful tendon is aggressively stretched, it has the same effect on the proteins - they swell up which disrupts the tendon structure and the tendon can’t do its job as well as it can.
So aggressive stretching can make tendon pain worse and won’t fix it...so what will?
It comes back to the reason why the tendon cell structure becomes disorganised in the first place, which is due to being not strong enough to handle the workload we place on it. Yes you could just remove the workload but that would mean potentially giving up a sport or favourite physical activity. The ideal way to fix tendon pain but maintain athletic activities and perform them well is to strengthen the brick wall so that it can tolerate what we ask of them.
Seek an opinion from a Physio on the best exercises to 1) reduce and get rid of the pain and 2) prepare the tendon for your sports, exercise and hobbies.
How can we help you?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our physiotherapists or expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced team today!