Load Management
Load Management
A tendon is the part of the muscle that attaches onto the bone. It is therefore part of the muscular structure, but its physiology is very different from a muscle. Tendons are fibrous connective tissue with the main function of transmitting the mechanical force of the muscle to the bone.
This fibrous tissue is therefore everywhere within the body – attachment of the rotator cuff, groin strains, patella, Achilles and to some extent the plantar fascia.
The Common Mistakes
1. Not prepared adequately to sustain the increased load
The most common problem seen in clinic is Summer footwear or inadequate footwear. When one decides on long walks or running, most people will change to appropriate footwear. However, we forget on holiday with flip-flops and plimsoles that we end up potentially walking a lot more than usual with no proper support. Or, in the case of the upper limbs, working with incorrect tools, blunt tools that increase the load when doing gardening or DIY.C
2. Workload is increased too quickly
The main factors that impact on the adaptability of tendons are load management (volume, intensity and frequency).
Trying to finish that job over the weekend, or increasing running training/gym training too quickly. Or as I have heard more than once over the past “ the holiday resort was very hilly”.
3. Weekly load is too high or not adjusted daily
Tendons needs time to adapt. The heavier the load ((volume, intensity and frequency) the more important it is to allow time for adaptation. We now recommend that heavy strength training should be a minimum of 2-3 days apart and if including plyometrics (jumps, hops skipping) at least 3 days (96 hours) apart.
Research from 2010 suggests approximately 80% of training volume should be low intensity and only 20% high intensity (e.g. Tempo runs and interval sessions).
4. When training is not fun
So many factors impacts on our ability to manage our bodies in optimum form. In some sporting institutes they ask the athletes to complete a questionnaire prior to every training session to understand the intrinsic factors that can have potential influences on your capacity to manage the workload. If we are able to enjoy what we do, the way our body responds, activate and prime in readiness for the activity, is crucial to sustain the capacity of the load.
Fun and enjoyment is crucial to our intrinsic motivation!
And lastly, just a good opportunity to re-iterate the messages that I so often say in the clinic.
- Complete rest is not advised, but resting from the aggravating factors e.g the repetitive movement invoking pain might be indicated.
- Starting to stimulate cell regeneration with appropriate exercises – whether that will be isometrics contractions or eccentric - will be determined by the pain, ability to manage and whether the tendinopathy is in the first stage or is degenerative.
- Any change needs to be done gradually with a suggestion of 10% progression each week.
- The body does adapt but it needs appropriate recovery time
- Easy movement/training can be good training.
- Stay focused with what you would like to be able to achieve and work within the parameters of your own tissue capacity.
- Look after yourself – embrace an attitude of self-care
- The overall rehabilitation back to normal function is a combination of the exercises and managing lifestyle (physical and mental).