Not all tendons and tendon pain should be treated the same. For example, we tend to consider Achilles tendon pain as wither insertional or mid-substance. When it is insertional we need to consider compression of the tendon against bone that occurs for example when you go into a lunge or the heel drops off the step. Other examples of compressive tendinopathy are the proximal hamstring compressing against the sit bone (ischium), or the gluteal tendons compressing against the outside of the hip bone (greater trochanter). In the case of compressive tendinopathy, we might want to avoid stretching to reduce compression for a period. This may be purposeful stretching like people are often (and maybe not helpfully) advised with tendon pain, or it may be more functional occurring with a habitual task (for example, sitting, hanging on the hip when talking to someone, or stair climbing). I am not saying that we need to place major limitations on every compressive tendinopathy, but we may need to limit for a period before reintroducing compression. Check out the video below as I discuss it more! If you want more info on the general topic of tendinopathy, click here.

 

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2 Comments

  1. Marcella

    I have one Achilles with insertional tendinopathy and the other with mid tendinopathy. I’ve been going on a year. Any suggestions would be greatly appreciated.

    Reply
    • Andrew Walker

      Hey Marcella, Sorry for the delay in replying! There are two sides to the equation that we can modify – 1) Load demands – we can reduce this for a time this with modified activity (e.g. runners running less miles, less hills, etc), modified equipment (more of a heel, less flat shoes); 2) Load capacity – we can increase this by heavy load exercises as long as the pain is not too significant. As this video talks about we don’t want to take the compressive tendinopathy into compression under load at first (and perhaps even when not under load depending how intolerant the tendon is of compression), but will need to reintroduce compression at a later stage.

      Reply

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