In this video, Anthony uses a model to illustrate and explain the varying stages of tendon injury. You will see how each stage is unique in both its presentation and required rehabilitation. Most importantly, you will see how loading the tendon is critical in all stages, as long as it is applied correctly, and that rest is rarely useful.
Transcript:
hi guys it’s Anthony from Grand Stand
00:02
and today we’re talking tendons we’re
00:04
gonna be talking about it how attendent
00:05
works normally what happens when a
00:07
tendon starts to break down and most
00:09
importantly how to fix a tendon which is
00:10
starting to break down so for today’s
00:19
talk we’re gonna be using this piece of
00:21
rope to demonstrate our tendon now our
00:23
tendon is just like this piece of rope
00:24
and that it’s made up of lots of little
00:26
fibers which are really well organized
00:27
and compacted to give us a whole lot of
00:29
strength in a tensile direction now like
00:32
this piece of rope a tendon does not
00:34
deal terribly well with rotation loads
00:36
nor does it deal well with loads where
00:38
it’s being bent particularly over a bone
00:40
or surface like that so a normal tendon
00:43
should look like this very very well
00:45
organized this next section of the model
00:47
represents a tendon after we’ve loaded
00:49
it like going for a run or after a game
00:51
of football and we can see that there
00:53
has been some damage occur to the tendon
00:55
now this is a good thing because this
00:57
damage is actually the stimulus for the
00:59
body to make the tendon stronger and
01:01
therefore able to deal with more loads
01:03
later in the future the most important
01:05
thing is is that we need to give our
01:07
body the right environment to repair
01:09
this damage and the right environment is
01:11
adequate rest and good nutrition to make
01:14
sure that the damaged following a load
01:16
settles down quickly and we repair back
01:18
to a normal stronger tendon if her load
01:22
is too high or a rest period is too
01:25
short the body struggles to deal with
01:27
the damage that we saw in the previous
01:28
model as a result it clean creases the
01:31
fluid within the fibers to try to make
01:33
the tendon stiffer now you can see in
01:36
this tendon here which is your typical
01:37
10 swollen tendon we’ve got fluid
01:40
gathering through there and the fibers
01:42
are starting to become a little bit more
01:43
disorganized if we continue to further
01:47
push the tendon without giving it addict
01:49
arrest then we start to see
01:51
neovascularization and
01:53
neovascularization is just a really
01:55
fancy word to say blood vessels and
01:57
nerves infiltrating into the tendon
01:59
matrix now this is a problem because the
02:01
blood vessels and the nerves are
02:03
sensitive and when they’re compressed
02:05
under load they produce pain and some of
02:07
the tendon pain you’re getting is from
02:09
the direct pressure
02:10
these tissues in there if you’ve had
02:13
tendon pain for a while you may have had
02:15
an MRI or an ultrasound which
02:17
demonstrated a tear of the tendon and
02:19
the tear is exactly what it sounds like
02:21
where you have a breakdown of some of
02:23
the fibers of the tendon now importantly
02:25
this tendon is never going to repair
02:27
itself and the tear will always be
02:29
obvious on MRI or ultrasound but that’s
02:33
not to say it’s going to stop you
02:34
getting back to your activity so let’s
02:37
review those stages of the tendon one
02:39
more time this time focusing on what we
02:42
do to try to make the tendon better
02:44
remember in our normal fatigue load
02:47
giving the tendon adequate rest and
02:49
nutrition is enough to have mouth
02:51
attendant not only to recover but also
02:53
to improve to be a stronger tendon for
02:56
next time you exercise once we’ve
02:58
developed some swelling in the tendon
03:00
it’s really a sign the attendant is
03:02
struggling to deal with the loads that
03:03
you’re placing on it now this time this
03:06
might be an appropriate time for
03:07
relative rest from the aggravating
03:09
exercise so if your tendon gets inflamed
03:11
after running giving yourself a short
03:14
break from running may be the best thing
03:15
for it
03:16
now importantly don’t stop exercising
03:19
all together in fact loading the tendon
03:22
up you know isometric exercises will
03:25
help to push the fluid out of the tendon
03:27
and return the tendon back to its normal
03:30
matrix if you’re one of these people
03:32
with this chronic degenerative tendon
03:34
you’ve got quite a lot of work to do to
03:36
restore the tendon back to normal this
03:39
tendon will not respond well with rest
03:41
and in fact rest will just make the
03:43
tendon weaker without changing the
03:45
nerves in the blood vessel which means
03:47
it’s even more unlikely for you to be
03:49
able to return to your exercise instead
03:52
what’s paramount is to start to load
03:55
this tendon and the loading does two
03:57
things
03:58
alright isometrically loading the tendon
04:00
you can desensitize the nerves and the
04:02
blood vessels to the compression whilst
04:04
also making the tendon stronger and more
04:07
able to deal with load but those of you
04:10
who’ve had a tear diagnosed on an MRO
04:12
and after Sarah keep in mind that that
04:14
tear is always going to be visible under
04:16
investigation that’s not to say you
04:19
can’t return to your
04:20
sighs but it does mean you need to load
04:22
the tendon appropriately to make the
04:24
remaining fibers strong enough to deal
04:26
with a normal load the aim of any good
04:30
tendon rehabilitation program is to
04:32
restore your tendon whether it best be
04:34
overworked swollen and inflamed
04:38
degenerative or torn back to a normal
04:41
tendon and this is absolutely achievable
04:43
with the right loading parameters
04:46
applied to it and avoiding rest the
04:50
other thing to keep in mind is that
04:51
within any one tendon you may have any
04:54
number of different stages going on at
04:56
different portions of the tendon and
04:58
that means it’s absolutely critical to
05:00
find the right load applied at the right
05:03
time with right recovery from able to
05:06
you to have a full recovery
05:07
I hope this model is giving you a little
05:10
bit more of an understanding of what’s
05:11
happening with the new tendon but also
05:13
the importance of loading a tendon
05:15
now if you’ve got any questions about
05:16
what’s the right type of load see your
05:18
attendant please give us a call at
05:20
grandstand
