Exercise Interventions for the Management of Tendinopathy
This lecture provides an overview of the efficacy of current exercise interventions for managing tendinopathy, and reviews the more up-to-date exercise prescriptions, such as the use of prolonged isometric contractions and tempo-driven strength training to suppress intracortical inhibition. Performing prolonged isometric contractions and exercising to the beat of a metronome have been shown to suppress cortical inhibition, and these interventions should be considered in the management of all tendon injuries. Rehabilitative exercises are discussed, including the importance of strengthening synergistic muscles in an attempt to offload the damaged tendon, the need to move through a full range of triplanar motion while performing rehabilitative exercises, and the benefits of strengthening tendons and muscles while they are in their lengthened positions. New research showing the importance of personalizing tendon rehab programs by modifying resistance to ensure tendon fibrils move through a very specific range of motion is discussed. Lastly, a detailed exercise protocol for managing non-insertional Achilles tendinopathy is reviewed and this exercise routine can be modified to treat any tendon in the body.
Learning Objectives:
- Understand structural differences between muscles and tendons, and the distinction between energy storing tendons and positional tendons.
- How structural differences in muscle and tendon morphology alter function.
- Understand the cellular mechanisms responsible for tendon injury, and how this affects treatment interventions.
- Review the effect of stiff tendons, and overly compliant tendons on injury patterns
- Learn the differences between heavy load eccentrics, prolonged isometrics, and tempo-driven strength training protocols.
- Improve clinical decision-making by learning how to personalize tendon rehab prescriptions.
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About the Presenter
Tom Michaud, DC
Since graduating from Western States Chiropractic College in the early 80s, Dr. Tom Michaud has published numerous book chapters and over 50 journal articles on subjects ranging from biomechanics of the first ray, to the pathomechanics of vertebral artery dissections. He has also served on the editorial review board of several chiropractic and podiatric journals.
In the early nineties, Williams and Wilkins published Dr. Michaud’s first textbook, Foot Orthoses and Other Forms of Conservative Foot Care, which was eventually translated into four languages.
His next book, Human Locomotion: The Conservative Management of Gait-Related Disorders, which was published in 2012, is used in physical therapy, chiropractic, pedorthic, and podiatry schools around the world. In addition to technical books, Tom also published a book for recreational runners: Injury-Free Running: How to Build Strength, Improve Form, and Treat/Prevent Injuries, now in its second edition.
During his 40 years of clinical practice, Dr. Michaud designed and patented numerous diagnostic tools and exercise products to help with the evaluation and treatment of a wide range of sports injuries. Since his recent retirement from clinical practice, Tom is devoting his time to researching, writing, and designing new products in order to develop evidence-based evaluation and treatment protocols that can assist in not just the prevention of sports injuries, but also in ways to stay fit as we age.
