Training tendons: What really matters for performance and rehabilitation with Seth O’Neill
Aug 4, 2022
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Seth O'Neill, an Associate Professor in Physiotherapy at the University of Leicester, discusses the role of tendons in dynamic movements and tissue adaptation. He explains the importance of tendon structure and how it can be influenced by factors like aging. Seth also explores isometric training and its benefits for rehabilitation. He delves into specific tendons such as patellar tendons and Achilles tendons, as well as calf training and monitoring. Lastly, he highlights the increased occurrence of calf injuries in sports and the correlation between calf strength and sprint speed.
Tendons can adapt to training and exercise, and their structure plays a critical role in tendon health.
Isometric training can be beneficial for reducing tendon pain and improving symptoms, but its effectiveness varies.
Heavy load and isometric training, specifically in the range of 80-90% of MVC, is most effective in adapting tendons and improving calf strength.
Deep dives
Tendon function and adaptation
Tendons serve as elastic energy storage devices, allowing for better propulsion and increased force output. The structure and material properties of tendons can adapt to training and exercise. Age does not significantly affect tendon structure if a person remains physically active. Structure plays a critical role in tendon health, as abnormal structure is a major risk factor for developing symptoms and injuries.
Principles of tendon rehabilitation
Tendon rehabilitation involves controlling symptoms, monitoring pain, improving muscle-tendon function, and progressing to sport-specific exercises. Education and load control are important in managing symptoms and reducing stress on the tendon. Isolated muscle-tendon function and coordination are crucial for proper tendon adaptation. Higher loads and plyometric exercises can be used to improve tendon resilience. Monitoring cumulative and peak loads in sports-specific exercises is essential for successful rehabilitation.
Isometric training for tendon rehabilitation
Isometric training has been used to reduce tendon pain and improve symptoms. However, the evidence regarding its effectiveness is mixed, with some studies showing positive results and others showing no significant benefit. Isometric training should not be considered a panacea and should be used as part of a comprehensive rehabilitation program. Individual response to isometric training may vary, and other exercises and interventions may be more suitable for some individuals. Muscle coordination and shock absorption are important considerations in tendon rehabilitation.
Importance of Heavy Load and Isometric Training for Tendon Adaptation
In this podcast episode, the speaker emphasizes the importance of heavy load and isometric training for tendon adaptation. High loads, specifically in the range of 80-90% of maximum voluntary contractions (MVC), have been shown to be most effective in adapting tendons. The speaker mentions the need to quantify calf strength and highlights the lack of attention given to calf training in the past. It is recommended to introduce heavy calf exercises, such as standing heel raises with an external load of around 50% of body weight, to improve calf strength and resilience.
Role of Pain Monitoring and Activity Modification in Calf Injury Rehabilitation
The podcast also discusses the role of pain monitoring and activity modification in calf injury rehabilitation. Pain is considered a gateway to progression, and monitoring post-activity soreness and its impact on daily life can guide the rehabilitation process. The speaker suggests using low loads and frequent training sessions (around 3 times a day) in the early stages of rehabilitation. Isometrics can be useful for loading the calf and quantifying its capacity, especially in cases of high irritability. Educating athletes about their symptoms and helping them understand their control and potential flare-ups is also emphasized. The speaker recommends aligning calf training with on-field demands, including performing exercises in different positions to stress various tendon fascicles and replicating cutting tasks and quick movements.
This week’s guest on the Pacey Performance Podcast is Seth O’Neill. He’s an Associate Professor in Physiotherapy at the University of Leicester. He has a PhD on tendinopathy and in this episode its all about the tendons, how we train them, how we reduce the chances of injury and how we rehabilitate them.
Seth tells us about the role of the tendon function and how it can adapt to dynamic movements. This includes the importance of tendon structure – and why this subject has been dividing opinion. Seth moves onto what causes changes to tendon structure, including ageing and how this can be mitigated for. There’s also some insight into muscle stiffness versus tendon stiffness, and how both affect performance.
Seth also discusses isometric training, including what does and doesn’t work for him in order to get the best performance benefits. He also talks about how isometrics can be the gateway to rehabilitation and how pain comes into the equation. He goes into specifics too, about patellar tendons, the Achilles tendon, and on to calf training and monitoring. This includes why calf injuries are now more common, and why hamstring injuries have plateaued in recent times. Finally, Seth tells us how to gain performance benefits through calf training. For all this insight and much more, hit the play button now.
This week’s topics:
The main question sports clubs ask Seth regarding physiotherapy
The role of the tendon function and adapting to dynamic movements
The importance of tendon structure
What causes changes to tendon structure
How much can age affect tendon structure
Muscle stiffness versus tendon stiffness
What does and doesn’t work in isometric training
How isometric training can be best used to get performance benefits
How isometrics can be the gateway to rehabilitation
Patellar tendon and Achilles rehabilitation
Calf training and monitoring
Why calf injuries are now more common, and hamstring injuries have plateaued
Gaining performance benefits through calf training
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