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Lower Limb Tendon Pain – What shouldn’t you be doing?

Posted on 28th November 2018 by

We love a good Infographic here at goPhysio, and recently came across this great one from @YLMSportsScience10 Things NOT To Do If You Have Lower Limb Tendon Pain.

Lower Limb Tendon Pain

Tendon pain in the lower limb, aka tendinopathy, tnodionitis, tendonopathies……like achilles tendinopathy or patella tendinopathy, are one of the most common type of injuries we see at our clinic in Chandlers Ford. It’s a side effect of having a pretty active, local population who regularly take part in exercise to help keep them healthy!

Tendon pain can be pretty frustrating to have. Firstly, because it often affects those that are naturally more active or sporty, so has a huge impact on being able to do what you love to do. And secondly, it can be difficult to know what to do for the best. There’s lot’s of conflicting information out there and can be a bit of trial and error to find the right solution and have a successful recovery.

So, this infographic, which illustrates some great, evidence based principles on managing lower limb tendon issues, offers some extremely useful guidance.

  1. Do not rest completely – we prefer the term ‘relative rest’. So advise that you avoid activities that directly aggravate your pain, but keep going with others or find alternatives. It’s important to carry on ‘loading’ (so getting your tendon to work) to help your recovery.
  2. Do not rely on ‘passive’ treatments – there is overwhelming evidence that passive treatments (so something that’s just done to you, whilst you lay there happily!) alone will not help with tendon problems. They can be useful in relieving your pain in the short term, enabling you to do some more specific exercises though.
  3. Do not have injection therapy – this advice refers to having an injection as the first line of treatment. If you’ve tried a consistent, high quality, exercise based treatment plan and it hasn’t worked, then injection therapy may be indicated or Shockwave Therapy is also a good alternative to consider for certain conditions.
  4. Do not ignore your pain – just like #1, use your pain level as a guide for your activity. Pain in your tendon is your body’s way of telling you it can’t really cope and you need to listen to it!
  5. Do not stretch your tendon – when you place your tendon on stretch, the lengthening action also compresses the tendon and this has been shown to affect recovery. There are alternative exercises to stretching that are significantly more beneficial to you.
  6. Do not massage your tendon – if it’s painful, it’s irritated. Massaging directly on the tendon is likely to cause further irritation and make the pain worse.
  7. Do not be worried about images of your tendon – try not to have a picture in your mind of what your painful tendon might look like on an ultrasound or MRI scan. Visions of or words like ‘degeneration’ or ‘tears’ can make you afraid of using your tendon, when actually, gradually building up what you do and with guided, appropriate rehabilitation is the best way of recovering.
  8. Do not be worried about rupture – reassuringly, most people who rupture their tendon have not had any pain. Because you have pain, you are naturally easing off what you do (if you’re listening to your body and respecting your tendon!), so you really don’t need to worry about the risk of rupturing your tendon.
  9. Don’t take short cuts with rehabilitation – it takes time for an injured tendon to build strength and capacity (ability to cope with the demands you place upon it). There are no quick, easy fixes unfortunately! With the right rehab, outcomes are excellent. That’s exactly why we now have supervised, exercise based rehabilitation at the clinic. So you can work on a customised, specific, evidence based rehabilitation programme that will give you the best outcomes.
  10. Do not have a lack of understanding of what loads are right for your tendon – this is crucial but not an easy concept for non-Therapist to understand fully. Gradually loading your tendon to optimise recovery is fundamental. What you should be doing and when can take careful management. Sometimes the internet or ‘Bob‘ at the Running Club, or @RunningLover on Twitter aren’t fully qualified or experienced enough to help you with this. You need to call in the experts, and that’ where we come in!

What is load?

If you read anything ‘rehab’ based about tendons, you will often hear the term LOAD and may be thinking what exactly does that mean?

Load can be simplified as the demands that you place upon your body. So, if you take your achilles tendon, when you walk you are loading it, running you are loading it even more, jumping loading it even more! If you go on your tip toes, you’ll be loading it; if you’re holding a weight whilst going up and down on your tip toes, you’ll be loading it even more.

So loading can be varied by weight, duration, number of times or how long you do something for, how high impact you are working at……….there’s lot’s or variations.

What next?

If you are suffering with a tendon problem, don’t waste any more time or prolong your frustration. Seek expert advise from us at goPhysio. We are able to offer you a full package of support, with as little or as much ‘hand holding’ as you need. Give us a call on 023 8025 3317 to book your first appointment.


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