Exercise Interventions for the Management of Tendinopathy: An Overview
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.
Course Preview
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Course Outline:
0-0:15 Review of muscle and tendon anatomy.
0:15-0:30 Mechanisms in which exercise can stimulate tendon repair: altered fluid flow dynamics and changes in interfascicular sliding, along with review of how the central nerve the system modifies motor output via intracortical inhibition.
0:30-0:45 Important alternate exercise interventions: The importance of tempo-driven strength training to suppress cortical inhibition. This section will also review how isometric contractions also function as pain blocks, the importance of strengthening synergists, and the rarely described importance of personalizing tendon rehab programs to ensure interfascicular sliding occurs through an ideal range of motion by modifying the load based on global laxity.
0:45-1:00 Specific rehab protocol for managing non-insertional Achilles tendinopathy.
Doctor of Chiropractic CE Approvals: Cleveland University – DC: AR, CO, DE, HI, IL, IN, NY, PA, WV, BC, ON, NS, NB, MB, SK, AB. PACE – DC: (Approval ID: 22525) AK, CT, DC, ID, IN, IA, KS, ME, MD, MA, MI, MN, MO, MT, NE, NH, NJ, NY, NC, ND, OH, OR, PR, RI, SC, SD, TN, UT, VT, VA, VI, WA, WY, NS.
Athletic Trainers CE Approvals: BOC: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY.
Physical Therapy CE Approvals: Arkansas Board of Physical Therapy: (Approval ID: APTA-AR 2517) AR. Physical Therapy Reciprocity. See below.: AL, AK, AZ, CO, CT, DE, DC, GA, HI, ID, IN, IA, KS, ME, MA, MI, MN, MO, MT, NE, NH, NM, NC, ND, OR, PA, RI, SC, SD, TN, UT, VT, VA, WA, WI, WY.
Course Instructor
