To understand the theory behind much tendon fixing, you need to understand the concept of Stress shielding. This is where the rest of the tendon jumps in to protect part of a damaged tendon.

The more the damaged tendon is shielded, the weaker it becomes. The more you try mild therapy on the tendon, the more the damaged bit of the tendon isn’t challenged or encouraged to heal. It just stays protected by the rest of the tendon, festering. This is why all effective treatments often require you to move into some type of pain!

To achieve a healing process the injured part of the tendon often needs to be accessed by load (often achieved in isometric, or eccentric exercises). Part of this process is achieved by making the rest of the defensive tendon release and stop its defending mechanism.

according to Baar – Stress Relaxation and Targeted Nutrition to Treat Patellar Tendinopathy

“Stress relaxation is a fundamental property of viscoelastic tissues like tendons, where force within a tendon decreases overtime when a static load is applied and the tendon is held at a constant length (Atkinson et al., 1999). Essentially, this means that when a tendon is loaded using isometric contractions, the collagen fibers/fibrils/ fascicles progressively relax over time, eventually reaching a steady state. As the collagen fibers/fibrils/fascicles relax, stress shielding within the tendon should decrease, and a directional mechanical signal should be imparted to the injured region. Consistent with this hypothesis, isometric loading protocols decrease pain in high-level athletes with tendinopathies“

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