Healing Chronic Scar Tissue in Tendons with Keith Barr
Feb 16, 2025
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Keith Barr is a researcher at UC Davis, focusing on tendon health and rehabilitation. He discusses groundbreaking techniques for reversing chronic scar tissue in tendons through specialized loading strategies. Barr explains the importance of isometric exercises for recovery and enhances performance while navigating the complexities of tendinopathy. Insights on how hormones affect tendon health and effective training strategies for runners to prevent injuries are also covered, providing valuable information for athletes and coaches alike.
Mechanical loading through isometric exercises is essential for rehabilitating chronic tendon injuries and managing scar tissue effectively.
Understanding the impact of hormones on tendon stiffness can guide tailored rehabilitation strategies that accommodate individual hormonal variations.
Focusing on the healthy tendon tissue while addressing chronic damage is crucial for improving overall resilience and injury prevention.
Deep dives
Tendon Tissue Engineering and Load Adaptation
Tissue engineering involves growing tendons and ligaments outside the body and subjecting them to stress to understand how they adapt. This innovative approach allows researchers to study tendon behavior and improve treatments for chronic tendinopathy. By isolating human ACL cells and placing them in an environment that mimics a natural scab, researchers can encourage the development of strong tissues. This method is pivotal in revealing how mechanical testing can indicate the right loading strategies for effective tendon regeneration.
The Role of Load in Tendon Healing
When treating chronic tendinopathy, it is crucial to address the surrounding healthy tendon tissue rather than just focusing on scar tissue. This approach enhances the resilience and strength of the healthy tendon, enabling it to better manage loads while symptoms of the degenerative tissue subside. The metaphor of treating the 'donut' rather than the 'hole' emphasizes the importance of building capacity in the healthy tendon to support the degenerative portions. By applying proper load through isometric exercises, practitioners can help realign and regenerate the disorganized collagen in the tendon.
Understanding the Mechanics of Tendon Stiffness
Tendon stiffness plays a significant role in both performance and injury; stiff tendons are beneficial for energy storage and efficient movement. However, when tendons become excessively stiff relative to muscle strength, the risk of injury increases. The distinction between types of stiffness is essential; the stiffness felt during pain may come from inflammation rather than a true alteration in tissue quality. By progressively loading tendons using a combination of isometric and dynamic movements, athletes can effectively manage and improve tendon stiffness.
Hormonal Influences on Tendon Health
Hormones, particularly estrogen and testosterone, significantly impact tendon stiffness and injury risk. In young women, increased levels of estrogen during different phases of the menstrual cycle can lead to more stretchy tendons, resulting in higher risks for injuries such as ACL ruptures. Conversely, during menopause, reduced estrogen and increased testosterone can lead to stiffer but more brittle tendons, raising the likelihood of tendon injuries. This hormonal interplay highlights the importance of tailoring rehabilitation strategies to an individual's hormonal status.
Practical Strategies for Tendon Rehabilitation
Incorporating isometric exercises into rehabilitation routines has proven beneficial for tendon recovery and injury prevention. Performing isometric holds for 30 seconds after running can stimulate the injured tissue, fostering healing while also managing overall tendon stiffness. Additionally, splitting longer runs into shorter sessions can double the positive loading stimulus received by tendons, enhancing recovery. Practitioners are encouraged to explore individual strategies that cater to their specific conditions, facilitating progress in rehabilitation.
In this episode of the Run Smarter Podcast, I sit down with Dr. Keith Barr from the University of California, Davis, to uncover groundbreaking research on tendon health, rehabilitation, and performance. Dr. Barr shares his expertise on tendon tissue engineering, the role of mechanical loading in healing tendinopathies, and how to reverse chronic scar tissue formation. Whether you're a runner struggling with tendon pain or a coach looking to optimize performance, this episode is packed with game-changing insights.
What You'll Learn in This Episode
๐น Why tendons develop scar tissue โ and how stress shielding plays a role in tendinopathy ๐น How to reverse chronic tendon damage โ with the right type of loading strategy ๐น The difference between tendon stiffness and perceived stiffness โ and how it impacts performance and injury risk ๐น Why isometric exercises are a game-changer โ and how to use them effectively in rehab and injury prevention ๐น The role of hormones in tendon injuries โ including how menopause and testosterone affect tendon health ๐น How to train smarter to avoid tendon injuries โ including the optimal way to structure your running volume
Key Takeaways & Actionable Strategies
โ Target the scar tissue with load โ Use isometric holds after a workout to gradually reintroduce load to the weak areas โ Donโt rush into plyometrics โ Start with long-duration isometric exercises before progressing to slow, heavy strength training โ Train twice a day for better tendon adaptation โ Splitting your runs into two sessions improves tendon recovery and adaptation โ Respect the first few sessions of new training โ The first track session, spikes workout, or hill session introduces high jerk forces, increasing injury risk โ Consider hormonal factors โ Women going through menopause may need to adjust their training due to changes in tendon stiffness and collagen synthesis
For MORE Run Smarter Resources ๐โโ๏ธ๐ - Including Free Injury Prevention Courses ๐ฉน๐ - The Run Smarter Book ๐ - Access to Research Papers ๐๐ - & Ways to Work with Brodie ๐ค๐ ๐ CLICK HERE! ๐โจ
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