Why Rest is Not the Answer

Have you ever had an ache or pain that no matter what you tried to do, no matter how long you rested it, it just didn’t seem to go away?

It wasn’t excruciating, but enough for you to notice it, and maybe even enough for you to avoid certain activities or using that joint in a certain way (i.e. not running or not pressing overhead). 

Maybe it felt better so you thought you could go back to doing those activities, only for it to flare up again?

Maybe this is just the way it is?

You’re not alone; we’ve seen this scenario literally hundreds of times.

It’s a condition called degenerative tendinopathy, which sounds scary, but it’s not as intimidating as it sounds.

So what is degenerative tendinopathy? 

For starters, there are two kinds of tendinopathies; degenerative and reactive. What’s also important to know about tendons is that they have poor blood flow, which causes them to take longer than muscles to heal AND why it’s so easy to end up with aches and pains due to overuse.

Now, let’s talk about reactive tendinopathy. Reactive tendinopathy (commonly referred to as tendonitis) is irritation to the tendon; think tennis elbow. In this instance, the tendon is irritated and inflamed, and rest is actually the solution short term (and you’ll know this because moving the area doesnt feel great) to allow the tendon to calm down and recover from the inflammation and irritation. The key once the irritation is gone is to strengthen the tendon to create a higher capacity for the activities that caused the irritation in the first place.

Degenerative tendinopathy starts as tendonitis (aka reactive tendinopathy). However, when you don’t rest in the short term to allow the tendon to calm down, it evolves into degenerative tendinopathy. 

Think of it this way; the tendon becomes overwhelmed with chronic inflammation, and because blood flow is so poor, the individual fibers within the tendon become disorganized and weak.

In the case of degenerative tendinopathy, it feels better to move, but it often feels significantly worse after you’re done exercising.

Here the prescription is movement, and maybe you’re thinking, “I’ve been moving! It didn’t work, that’s why I tried rest!” but it’s essential to do the right kinds of movements that are beneficial for tendon health.

Types of movements that will make degenerative tendinopathy worse (prior to and while the tendons healing) are repetitive cyclical movements. These are movements like running, jumping, cycling, bounding, repetitively swinging a club or racquet, or throwing; think anything with a bouncy or springy motion or anything that’s repetitive at a high intensity.

What’s the right kind of movement?

We use heavy, slow resistance, and this is something that we use with 100% of our clients who have tendon pain or discomfort.

So how does heavy, slow resistance work?

It requires moving weight at about 8/10 level of difficulty at a slow tempo.

If we use the example of knee tendinopathy, this might look like a back squat or a split squat with a weight that is an 8/10 level of difficulty, at a tempo of 3 seconds down/3 seconds up within a range of motion that keeps symptoms at a 4/10 or less.

The symptoms stay at a 4/10 or less, staying the same or better as we go (remember our pain rules from last week?!) is critical here because remember we are already dealing with irritation, and we don’t want to make it worse!

Why does this work?

Remember that tendons have poor blood flow. Spending time under tension (the 3 seconds down/up) is how we get around that issue! It allows the tendons to heal by absorbing nutrients and making it easier for the fibers to be reorganized.

If this sounds like you, you don’t need more rest; you need to get moving and load it up!

If you need help on how to do this specifically, we would love to speak with you!

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