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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The stuff tendons put up with!

If you have tendon pain, the chances are you don’t really understand the concepts of load and capacity. Nature offers a smorgasboard of stresses and pressures to help you screw up your tendons. I think someone once said suffering is good for the soul, and tendons believed them . Tensile, compressive, and shearing loads can get a tendon pain party well and truly on the way!

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Flexibility, trigger points and fuzz

No modern discussion of flexibility, trigger points or pain is complete without talking about fascia.

I was introduced to fascia by Julian Baker of the Bowen technique during some guided dissection sessions back in 2012 ( which means I have dissected corpses as part of my studies).

Its the “sort of fatty stuff directly under your skin
See here

Years ago this “stuff was simply cut away by laboratory assistants so you could see the actual muscles.

It’s only now that people see this as a new communication highway for our endocrine, circulatory, or nervous systems.

Today much “tightness” is attributed to dysfunction in the fascia. Although this is far from proven it’s useful working hypothesis that makes us focus on trigger points. They are “a hyper irritable locus with a taut band of skeletal muscle, located in the muscular tissue and/or its associated fascia.”

Sometimes called knots, trigger points can be quite painful, will cause stiffness and weakness of the affected muscle, and restrict the muscle’s full range of motion.

Fascia can also stick to muscles in what Gill calls “fuzz” ( if you cannot pick the skin off your muscle, its arguably adhered and interrupting muscle function, reducing range of motion

When poking around your body, you can often find what needs attention if
1. You press on the skin, and its super painful with pressure
2. you cannot pick the skin away from the muscle. This should glide, not stick
3. You feel special tension in an area when you stretch

This is sorted by,  being bothered enough to do something about it. Practically that means a mix, but consistent mix , of gentle (and not so gentle) massage, skin rolling and pressure applied by your fingers, objects, cupping, or better still someone else.

This stuff goes under the heading of Myofascial Release.

It’s uncomfortable which is why few people use it or do it. Sort of like flexibility. You have to get used to that weird discomfort.

The problem is that medically, no one wants to be a muscle doctor. So it’s the orphan organ.

If you have enough flexibility to squat, why do you need more. Crucially, if you cannot squat well because of flexibility who cares. Most lift the weight anyway, and if they screw their back who cares!

Stretching is uncomfortable, boring, the evidence is very conflicted and many charlatans insist that flexibility is a “star gate” to spiritual well being and enlightenment. This obviously puts any right mind individual off stretching.

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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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