Tendonosis

[Johnny Mnemonic]

I found this interesting article on rehabilitating tendonosis. I have tried incorporating some of the methods in my own training and so far so good.


www.bodybuilding.com/fun/drryan13.htm

[Boris]

Interesting read Johnny! Thanks for the link. I really wonder why I've never heard of tendinosis... Maybe it's just my lack of studying but I don't think I've ever seen anything on it before...

One thing that I wondered though is that aren't the following protocols pretty much the same when rehabbing for most things:

Determine the painful movements.

Warm the area up with lighter weights/slower movements.

Train the painful motion using lighter weights/slow movements at first, then progressing to faster and faster movements.

Train at speeds to complete a movement at very high speeds for time intervals of 15, 30, 45, 60 seconds. Special equipment may be required or use of therapy bands.

Reduce the speed and use more weight (1-10%) still maintaining a slower speed at first, and then progressing to a higher speed. Use the Weider pyramid principle to include speed sets with heavier sets.

Anyway, definately some good stuff. There were more than a few times that I thought ice didn't seem to be doing me any good and this would explain the condition.

[Johnny Mnemonic]

I think your right for the most part. A lot of rehabing protocols have many of the things mentioned in the article. But I think two things that most people don't realize.

1) Most people think they have tendonitis but in most cases it is tendonosis.

2) High speed used as a mode of an exercise is not mentioned in most rehabing situations.

This was one of the most helpful articles I have ever read!

[Antanas]

Yeah I've been researching in this mode of rehabilitation, i first noticed it because Mark R talks about it on his forum www.strengthmill.net/forum/showthread.php?t=700

Very interesting i am currently rehabbing a stupid knee injury and an old nagging shoulder problem and going to publish my next article on knee rehabilitation ( I only talk about what i have experienced), im going to follow this protocol and try to help all athletes in my situation.

Any input or injury experience would always help.

P.S i am going to see a physiotherapist and will try to discuss some of these issues with a professional and to have some maintenance work done.

[Boris]

Hi Antanas,

I read that thread from Coach Rippetoe - thought it was good, but just about any athlete will follow a similar protocol if injured and trying to fast-track their recovery back to competition.

Knee issues are something I've had little first hand experience with. I've worked with a few kids who had Osgood-Schlatter's syndrome and most did fine with a PL squat, but others did not - I don't know if it was a mental game or purely physical. Regardless, (and I know I'm referencing Siff here but I don't know where exactly he said it) rehabilitation is as much a proprioceptive and mental comeback as it is physical.

[Antanas]

I think people underestimate the mental part of athleticism and any aspects of. Should their be anything i should discuss with the physiotherapist besides the inflammation debate, joint stabilization techniques and imbalances?

P.S By the way re-watching all of your videos, im sick and tired of injury and i know it has happened.
I've spent time re-learning all my lifts and paying more attention to the squat, everything actually.
I have a goal not to injure myself at all in 2008 and reach a perfect form 200kg squat.

[Boris]

Sorry you're having issues Antanas. I wish I could give you tips for faster rehab, but all I can tell you is that I've had my share of issues squatting and usually it was because I was pushing things too hard, too fast for too long and ignoring recovery, flexibility, and auxiliary work.

I remember my father saying something to Johnny once (and I didn't really think much of it at the time) to the effect of you can 5x/week hard, but only for 2-3 weeks. That's about as long as you can maintain that. I don't know if Johnny remembers that, but I put it in a (mental) file somewhere and remember it everytime I don't follow it and get injured... Just about every concentrated loading I do is good for about 2-3 weeks and then, unless you are young/gifted/'enhanced', you'll need to back off. Just some thoughts.

[Antanas]

Sounds like good advice, never having any coaching to fall back on i had to wing it on my own and as many lifters make hundreds and hundreds of errors. Which i am paying for now still at an early age.

You just described me in couple words exactly. Currently waiting for my copy of starting strength 2nd edition and going to go with Rippetoes program and then move on to a more Westside type of method. (simply because im an athlete , well like to think i am,)

Just trying to get my head around the Western and Eastern periodization methods and catching up on some history, o how wrong i was. I'm still young definitely not gifted in terms of biomechanics and somatatype, the only thing im currently have going for myself is the mental game, stubbornness and some sort of smartness, thanks a lot to my upbringing not to say that i didn't make gains in what i call "dark days"

[Antanas]

Finally seeing one of the best physiotherapists so far one of the things he addresses mainly is tightness and adhesions (nothing new there) but the way soft tissue work is performed.

I have fallen into bad physiotherapists hands before thanks to the NHS; compared to him she was a complete idiot. I had experienced very negative response with ultra sound so I was sceptical this time.

But he explained to me, the way he uses ultrasound and heat therapy is to prepare the muscle, ligaments and tendons for further lengthening work. The way he performed all of his work was examine the tight areas in my case a very tight IT band around the knee, the insertion point near the hip, partially tight hamstring, tight hipflexors and soleus and other various points which at my current level of understanding i cant describe.

He also worked on shutting off and or relaxing the entire quad area, which in the end worked wonders on the over all tissue quality and length. I feel much better even though i still experience some pain (natural healing process).

Now I am going to see him again but this time he is going to evaluate how well I responded to the treatment and the next part in this healing chain. Another peculiar thing he did is perform gentle bruising or as he called “awakening" movements on the ligaments around my knee area with his thumb.

[Johnny Mnemonic]

Yeah, I don't remember your father saying that Boris. But it sounds right on. And welcome to the forum Antanas. You bring up some interesting topics.

[Antanas]

Thanks for the warm welcome and to get it out the way before anyone asks call me Ant, its much easier. Easy explanation not a Western name, it's an Eastern name as in Eastern European.

Just some food for thought once the lateral tightness has been released would it be beneficial to perform weighted exercises with light loads. For example light squats, deadlifts or sled dragging to increase blood flow to the injured limb and other various benefits mentioned in both of the articles to speed up the healing process?

P.S the physiotherapist involved mentioned no squatting as its still early in the healing process 2-3 weeks, i think this is a general opinion by all medicine professionals that isn't backed by scientific proof.

[Antanas]

Today after 3 weeks of resting, allot of glute and VMO activation work i went back to the gym. Well not to train fully but to try to speed up the healing process, using the Rippetoe method.

Concentrated allot on form, full depth and engaging correct muscles during the lift. Not much pain, can say none at all really. Had some tightness when hitting depth but my other knee is noticeably more tight than the injured one (weird huh?)

Iced after activity, noticed a drop of repetition tolerance. Squatted 3x20 just with the bar. Performed some chin ups, push ups and worked allot on the strict press. Also mess around with the tabata method and it really kicked my ass, had to finish early before i spat out my lunch.

This was just to get me back on the road, injuries really mess with my head, had to push myself allot. Next time when i visit my physio, i want him to work on my other knee tightness and try to work on the injured knee and aid full recovery.

P.S Some Rawgrip T-s arived , they looked pretty good.

[Boris]

Definately take your time getting back into it Ant. The healthy knee has probably been (and probably still is) compensating a lot for the injured one and that's no doubt why it feels tight - a knee injury can have a way of snaking its way to other areas, like your lumbar or ankles if you're not patient and diligent.

[Antanas]

So would single leg movements be more beneficial?

Felt good after yesterday, iced as usual. Swelling seems to be nearly gone. Warmed up good, didn't feel much pain when hitting full depth. Quad seems sore especially the vmo, in a good way sore, not re-injury pains. Added 20lb+20lb on the bar to a 3x20 squat.

Hit some heavy rows and heavy hyperextensions and some straight leg sit ups. Aim to get back to full strength and bring up my hamstrings,glutes and core to a high strength level. Still witting the article just need more time. Going to the physiotherapist after easter to check up on the injured knee and to work on my tight left one.

Happy Easter

[Boris]

antanas said:

So would single leg movements be more beneficial?

Maybe - hard to tell Ant. I like pistols etc, but I always overdo them when I start including them in my own training.

antanas said:

Felt good after yesterday, iced as usual. Swelling seems to be nearly gone. Warmed up good, didn't feel much pain when hitting full depth. Quad seems sore especially the vmo, in a good way sore, not re-injury pains. Added 20lb+20lb on the bar to a 3x20 squat.

Take your time. After a hip/lower back issue, I ended up w. a VMO injury because I was unknowingly shaving my reps a little short and had altered my technique... If VMO soreness is something you don't normally get when squatting, then it means you've changed something.

Happy Easter Ant.