As an athlete, patella tendon pain was excruciating, and then it became something I tried to train through. But it was always there in my mind, is it going to hurt when I run, when I take off?
At the time I followed the guidelines of how to treat tendon pain. And nothing really helped. Steroid injections, High volume injections, tendon and bone pecking, Loaded eccentric training. Lots of loaded eccentric training.. it was tedious, and improvements did not happen quickly enough for a frustrated athlete.
There were mixed messages of rest and therefore decondition, or train but run the risk of continuing with your poor form and perpetuating your compensations.
So I continued to train with adjustments. I adjusted my run up in order to put less strain through my tendon and on one session my tendonopathy went to a full thickness tear.
In reality how much does your body make its own compensations and adaptations when it instinctively knows it needs to protect you from further injury? So then on top of the tendonopathy you then present with altered movement patterns that become engrained.
What do you treat first- the tendon pain or the mal-adapted movement compensations? And which one is the primary driver?
As a former elite athlete and a physio I have been on both ends of wanting to rehabilitate tendon pain.
I have felt the frustration of trying to rehab clients who need to continue training and competing with tendon pain.
I know what rehabilitation works, and I know the people who are willing to let their guard down and really analyse how they move, and learn how movement feels will be the ones who can resolve their tendon pain.
It takes time, commitment to change basic movement patterns. This is so hard for an athlete who has been drilled and drilled into moving a certain way, or a runner who just loves to run mile after mile, or a parent who just needs to get out for a quick run and doesn’t have the time to do the necessary work to allow them to run pain free.