Tending to your troubled Tendon.

Tendon Injuries.

Injured tendons are way more tricky to rehab than injured muscles. They require patience, therapy and hard work. Bones heal in a few weeks, tendons can take ages. An article came out recently in the British Journal of Sports Medicine. I have tried to summarize the article into layman’s terms and then, at the end of the blog, added some thoughts of my own. I hope that this is helpful. The link to the article will be found below.

So, lets get the summary going. 

1. No one really understands why tendons get damaged. There are various theories, but the beginnings of the injury remain elusive.

2. Small samples taken from injured tendons have shown that there are typically high levels of lactate in the tendinosis (that’s just a fancy term for an injured tendon). High levels of lactate mean that the tendon might be hypoxic, or, in more simple terms, the tendon has not received enough oxygen.

3. Testing done on injured tendons also showed that their fibroblast cells were necrotic (oxygen starved), arteries were blocked and anerobic enzymes were high. Bottom line, affected tendons were not getting enough oxygen.

4. Part of the problem lies in the fact that tendons are poorly vascularised in any case. We ask a lot of them. It’s estimated that your achilles tendon will have to tension and pull your foot upwards more than 3 billion times during your life. Starve the tendon of enough oxygenated blood, and the tendon will attempt to rebuild itself with what is described in the article as, “poorly organized tissue”.

5. An injured tendon will secrete angiogenic growth factors, these chemicals start up a physiological process whereby new blood vessels are created from pre-existing vessels. The problem with these new vessels is that they tend to leak, and so the area still gets starved of oxygenated blood. Current thinking includes trying to develop a medication that would help increase the integrity of new blood vessels.

My thoughts with regard to injured tendons.

Part of the process is to work out why they got injured in the first place. This can be tricky, but one should always try and get to the cause.

1. Check shoes when it comes to an Achilles tendon. Excessive pronation should be dealt with.

2. Look at training loads. Sudden increases in both speed and distance must be taken into consideration.

3. Look for changes in running gait. I have had a number of injured runners with tendon issues that have gone for gait modification, which basically had them trying to land on the forefoot until they half destroyed themselves.

4. Look at your diet. I wrote an article on RED-S. RED-S stands for Relative Energy Deficiency in Sport. Simply put, a lack of food might compromise your tendons.

5. You need to learn how to load the tendon eccentrically with increased load over time. Get someone who understands the process help you with this.

6. Lastly, I would suggest making use of a hyperbaric chamber to speed recovery. Hyperbaric oxygen therapy dramatically increases levels of oxygen in your blood stream. The oxygen makes its way to every part of the body including poorly vasculated tendons.

Click on this link for the original article.

Hope this helps, and that your tendons are all strong and healthy.

Regards,

Mike Roscoe.