Tendon Health
By: Dr. Matt McGowan, D.C

As I reflect on my journey back from a ruptured bicep tendon over the last 4 months, I felt it imperative to pass along important information regarding tendon health. My injury was 100% due to overuse. “Overuse is often synonymous with terms like ‘Chronic Degeneration or  Repetitive Stress’.” Over time if we continually use a joint in the same repeated patterns under any load, we can be causing a long term negative effect on our tendons integrity at that joint.  A person can be very active, and in relatively good health and have unknown problems brewing at their tendons. Statistically, males in their 40’s-50’s tend to be subject to tendon failures the most, but it can honestly happen to anyone who repeatedly loads their tendons.  

So what does it mean to cause repetitive stress on a joint?  It can be a multitude of scenarios; an example can be someone who works with their hands often, a mason lifting and cutting stones over and over again. It can be the pickleball newbie that is so excited about the game that they play 4 times a week for several hours at a clip. It can be the person who has been doing the same exercise routine in the gym for the last 30 years with little to no variation. Any of these scenarios can demonstrate how simple activities that we take for granted can be causing a long term overload on the tendon.  

The hardest part about these injuries is that there are often no warning signs. I never had any pain in my bicep, it never felt tight. In fact most people who rupture their Achilles tendon, never have any warning sign until it pops. The good news is that there are ways we can alter our training to help avoid these tendon issues and ruptures. The most challenging part is staying self aware of our activities and loading patterns and being self accountable to make ourselves do the preventative work. This is where I failed myself. I did not respect the amount of load I was putting on my biceps on a daily basis. If I had taken certain steps in how I train, this may have been avoided.

What I feel are the most three most effective ways to avoid major tendon failure are:

1. Proper nutrition. Avoid any foods that have an inflammatory effect on your body. Try to limit cheat meals and highly processed foods.
2. Vary your activity as much as you can control it. Obviously if your job is working on a factory line, you cannot change this, but if you are a runner who loves to jog on a treadmill 5-6 times a week and you never change from that, then adding in other forms of exercises in replacement on 1-2 days can go a long way. 
3. The most important thing you can do is include eccentric loaded exercises to your routine. The eccentric phase of the exercise is commonly known as the negative phase. The most simple way to explain a negative phase is the phase in which you return the weight back to its starting point. It is when the muscle is elongating. For example with my bicep, normally when people lift weights for biceps there is a smooth cadence of 1-2 seconds pulling up, and often 1 second going down. The key for tendon health is loading the muscle on the way down in a slow and controlled manner.  

A great start for anyone who feels that they may find themselves undergoing repetitive load or stress should take the following steps:

1. Figure out what joint/tendons may be under repeated stress.
2. Figure out what exercise can be done to load that tendon directly.
3. Perform 3 sets of 12-15 repetitions of that exercise with following cadence:

2 second concentric phase (shortening phase)/ 5-7 second eccentric

(lengthening phase)

Not every exercise of every workout has to be done in this manner, but adding this in every few weeks is very important to preventing tendon breakdown. If you feel like you may be exposing yourself to tendon overload but do not know where to start or what exercises to do, come in and get it evaluated and we can certainly help you out.