Tendinitis, tendinosis, tendinopathy. Lets call the whole thing off

The older your therapist or trainer, the more likely they are to muddle up what to call your tendon pain. The younger your trainer or therapist, the more likely they are to waste your time with an obnoxious mini-lecture if you use the wrong word.

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Tendon pain, gelatin, and collagen.

In our obsessive pursuit of stronger muscles and hearts, we’ve failed to understand how to train and feed connective tissue like ligaments, tendons, bones, and cartilage.

Almost everyone is told that the tendon doesn’t have much of a blood supply and takes ages to recover from an injury. We do nothing with this information.

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Tendons and Fluoroquinolone

Fluoroquinolone is a super popular drug! Its an antibiotic that appears in these trade names

  • ciprofloxacin (Cipro)
  • levofloxacin (Levaquin/Quixin)
  • gatifloxacin (Tequin)
  • moxifloxacin (Avelox)
  • ofloxacin (Ocuflox/Floxin/Floxacin)
  • norfloxacin (Noroxin)

    The NHS explains the risks and rewards of these drugs here
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Do at least 10,000 steps a day

“10000 steps a day. Yep, that’s 10 thousand steps every day . Go and buy a cheap pedometer or look up if its already on your phone,, and record how many steps you take each day. This is your baseline of daily activity. Any gym work or running around is training and is extra . This is the minimum amount of movement you do to keep ticking over.

Frequently I see people work quite hard in the gym for an hour, but are totally sedentary for the rest of the time. The gym session barely compensates for their lack of day today movement.

I also see many sports people, who apart from the weekly football match, are to all intents and purposes, sedentary.  So,  put that pedometer on, check your phone and review your daily count.

Lifestyle IndexSedentaryLow ActiveSomewhat ActiveHighly Active
Steps/day*<50005000 – 75007500 – 10,000>10,000

But don’t worry! slowly build up your activity level if you find yourself in the sedentary box! Get active at work

for some science, look at

Effects of a 10,000 steps per day goal in overweight adults” by Schneider et al (Am J Health Promot. 2006 Nov-Dec;21(2):85-9.)

Some points need to be made

1) the 10,000 steps is a fantastic way to assess basic activity. Ive helped people who could  only manage 3000 steps in a day and the effect was remarkable.

2) 10,000 steps a day is the very least you should be doing.

However,  if you present 10,000 step Versus almost anything else, anything else is probably better: Brisk walking is better, a  fast 400m  run or a Crossfit Workout is better, indeed a  life and death brawl at your local pub really gets the blood pumping. The issue is this: you have to really be sedentary to do less than 10,000 steps a day, so its  a great baseline and target and you should always do more.

3) the message is “do both”.

So, its 10,000 steps each day, plus a workout

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Foot exercises

Try and do the foot exercises below. Your feet will love you, and you will also learn to love your feet. This type of activities are also helpful in your battle against plantar fasciitis.

Towel curls

Scrunch your toes, with or without a towel. Just think about the position you leave them in normally. Straight and  locked in your shoes like prisoners. To paraphrase Marie Antoinette “Let them scrunch air” or treat them to a  scrunch festival on a towel! Give them some manoeuvering room.

Toe splays

Splay your toes: see if you can  splay them.

It was a bit of a battle for me to learn how to do this ( as, like you I’ve locked my feet into shoes for the last  years, so I alternate the splay with using my fingers to pull them apart ( you can do it en-mass as shown here or individually )

Big Toe stretch

Slowly stretch and pull the toe backward toward your shin. Go as far as is comfortable.

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Alfredson and eccentric drops.

I refer to this  “genius” so often, that I thought I should post up this reference here.

Alfredson H Pietila T Jonsson P Lorentzon R. Heavy‐load eccentric calf muscle training for the treatment of chronic achilles tendinosisAm J Sports Med. 1998;26(3):360‐366. [PubMed[Google Scholar]

This is a report that has changed the lives of so many people, it’s ridiculous. It’s basically stretching a tendon through its eccentric phase, under load.

Here is a much younger me trying it out, back in the days when I was sufferer!

For those who want to dig further into this issue, check out this useful review.

The free course to fix your achilles pain is here

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