Exercise Prescription in Tendinopathies

Question 1

Reactive/early tendon dysrepair

Answer 1

Reduce load/adjust rest period.
Identify biomechanical overload source (valgus, weakness).
3 day rest period due to type 1 collagen peak.

Question 2

Late dysrepair/Degeneration

Answer 2

Eccentric exercises shown to improve tendon structure, pain (changes within 4-6 weeks). Pain can be up to 5/10 as long as it doesn’t stay for more than 24h and doesn’t get worse.

Question 3

Fundamental aspects of Tendinopathy Treatment

Answer 3

Exercise primary intervention.
Progressive strength, endurance and functional program.
Complete rest is contraindicated!
Identify load/volumes that cause pain.
Monitor with VISA questionnaires.
Min 12 week program.
Education fundamental! must know that rehab will be long and complicated.

Question 4

Lateral Elbow Tendinopathy

Answer 4

Low Risk: wait and see, reduce or modify pain provoking loads.
Mod Risk: Manual therapy, progressive resistance, motor control, general UL.
High Risk: Prescribed meds, isometrics.

Question 5

Achilles

Answer 5

Calf muscle exercises cheap and widely available.

Question 6

Patella

Answer 6

Eccentric! or slow heavy resistance.
Decline squats (2 x 15 reps, 2x day for 12 weeks).

Question 7

Patella

Answer 7

Eccentric! or slow heavy resistance.
Decline squats (2 x 15 reps, 2x day for 12 weeks).