When people start a new fitness regimen, most think about building muscle strength and mass.
But our bodies are more than just muscles.
At the ends of our muscles there are these thick collagenous fibres called tendons and they connect our muscles to the bones. Since they’re found at the ends of muscles, that means they’re also found around the joints.
They not only help move our joints around, they can also act as shock absorbers for our muscles. So when you land, stomp, or run, they’ll help take a lot of the brunt of the impact.
Likewise, they also help release energy. Think of them like springs! They help propel you when you run, walk, and jump.
So how do you strengthen them? Let’s take a look.
SOFT TISSUES TAKE TIME
When you start working out at the gym, it’s common to notice some muscle gains within just a few weeks. But the soft tissues? Pfft.
Soft tissues take their sweet time.
Why? Well, it’s thanks to what they’re made of.
Tendons and ligaments are both made of dense connective tissue, mainly strong collagen fibres. The catch? They don’t have a lot of blood supply to them. Barely any, in fact.
That’s why it can take up to 12 weeks to see any changes in these soft tissues.
NO STRAIN, NO GAIN
When tendon pain arises, a lot of people stop everything they’re doing and hope the pain just goes away. This is the LAST thing you want to do. With complete rest, you’re just allowing the tissues to become even more deconditioned.
Remember, the tendon's job is to help the muscles move the body around, while also absorbing and releasing force. If your tendons are rested for an extended length of time, chances are they’re not going to be able to cope when you do eventually get back to doing whatever it was you were doing before.
A lot of people will simply resort to icing, heating, using a compress, or some other gadget like a TENS machine on the damaged tissue. Not that these modalities are wrong, they definitely have a place when it comes to rehab and pain management.
With that being said, if you don’t actually strengthen the healthy tissue around the affected area, chances are you’ll just end up with more unhealthy tissue in the future.
Below we’re going to take a look at 3 ways to strengthen tendons: isometrics, progressive heavy loading, and plyometrics.
But first, let’s take a look at some principles that apply to all areas of training, but especially when it comes to training around pain.
APPROPRIATE LOADING
When dealing with any injury, it’s completely normal to have some pain and discomfort with training. You don’t want to be in excruciating pain, but a little should be expected, and might even be better in the long run for you.
Think of pain as a scale of 1 through 10, with 10 being extremely painful. You want to get to a max of 3-4 on that scale. Anything more than that, and you’re going to want to turn it down a bit.
Another thing to keep an eye out for is to see how your body reacts after a training session.
If you're feeling completely fine the next day, then you're in the clear.
If you have just a little bit of tendon pain the next day, you're probably fine.
If you have a noticeable jump in tendon pain the next day, you're going to want to tone it down next time.
It’s all about listening to your body.
There are 2 easy ways to turn it down a notch:
Lower the volume (less reps/sets)
Lower the intensity (less load or time)
Lower the frequency (less days per week)
If those strategies don’t work, that’s where modifying or replacing the movement you were doing would be helpful.
This could look like:
Using less range of motion (half squat vs full squat)
Using 2 limbs instead of 1 (double leg calf raise vs single leg calf raise)
Using a regression of an exercise (split squat vs walking lunges)
When looking to schedule your workouts, you want to try to space the strength training workouts at least 48 hours apart. This will give your body the time to rest and recover properly between bouts. With isometrics, though, you might be able to get away with doing everyday without aggravating the soft tissues.
ISOMETRICS
What exactly are isometrics? It’s basically when you just hold a position while your muscles are contracting. Think of a wall sit for example.
Isometrics can be a great way to introduce the affected area to training again. It’s usually well tolerated, doesn’t cause excess fatigue or stress to the area, and actually has some pain relieving benefits!1
👉Just take a look at our last blog to read all about it.👈
Another great thing is that they can be done basically anywhere, you can get creative with them, and you can start off with just using your own body weight.
Here are some examples:
Wall Sit
Spanish Squat Hold
Leg Extension Isometric
Calf Raise Isometric
Pushup Position Hold
Shoulder External Rotation Isometric
When you’re just starting out, you can aim to hold isometrics for around 10-30s for 2-3 sets, and slowly progress to longer holds in the 30-45s range for 3-5 sets.
MORE ADVANCED ISOMETRICS
There are other, more advanced versions of isometrics such as Overcoming Isometrics and Eccentric Quasi-Isometrics.
An Overcoming Isometric is when you try to move against an immovable object. What ends up happening is that you end up pushing so hard that you fire up a lot more muscle fibres, but you’re still not moving because whatever you’re pushing against is not giving way.
Here’s an example: You get into a squat position with a bar on your back, and you get underneath the hooks on a squat rack. So now, you start trying to squat up, but the hooks are stopping you.
An Eccentric Quasi-Isometric is when you start off in an isometric, but the longer you hold it, the more your muscle simply can’t handle the load and you slowly start lowering. Hence, the eccentric - the muscle stretch portion that usually comes with the lowering portion of an exercise.
An example would be in a Seated Leg Extension, where you sit in the machine and kick your legs up to the top position and hold. Eventually, you’ll start getting tired and you’ll start having to lower the legs back down.
Again, these are more advanced techniques and are more strenuous on the body. These are great to build up to, though, as they can challenge the tendons a little more. So if you’re looking for some serious tendon training, these are a great addition.
PROGRESSIVE STRENGTH TRAINING
Strength training is the bread and butter of any gym go-er or fitness enthusiast (or at least it should be), and it’s the second stage of strengthening tendons.
What do we mean by progressive, though? Well, it means that you’re looking to
progressively increase the difficulty as your body adapts to training.
This could look like increasing the reps or sets, increasing the weight you’re using, or choosing a harder variation of an exercise you’re doing.
Depending on your stage in your rehab journey, you may start off using just body weight exercises. Eventually you’ll want to progress to using some resistance like weights, bands, or cables.
When it comes specifically to strengthening the tendons, though, you’re going to want to lift HEAVY.
How heavy exactly?
About 70-85% of your maximum heavy.2
This equates to doing an exercise for 5 to 12 reps before not being able to do any more.
For example, if your best squat is 100lbs, you’re going to want to build up to lifting between 70 and 85lbs.
Lifting heavy loads helps promote collagen synthesis in the tendons.3 And the bonus? You’re also strengthening your muscles. Who doesn’t want that?
Like it was mentioned above, you want to monitor and see how you feel the day after training and then gauge the appropriate intensity from there - you don’t want to have lots of pain, swelling, or any type of aggravation 24 hours after your session. So just keep that in mind and remember to adjust accordingly.
ADDING PLYOMETRICS INTO THE MIX
Think of plyometrics as jumping, landing, running, and any other fast and explosive movement. These movements produce the most stress on the tendons, and so they are usually saved for later on in a rehab program.
Explosive movements require stiff tendons, which is why heavy lifting is a prerequisite as that helps build up tendon stiffness. But plyometrics can further train stiffness in the tendons and can help build up back to activities like jogging, hiking, tennis, pickleball, soccer, etc.
So in order to progress from the strength work mentioned earlier, and the sports and activities mentioned above, there needs to be a bridge to cross this barrier.
That is where a plyometric progression comes in.
Jumping, landing, accelerating, decelerating, changing direction, all need to be progressed to give your tendons the best chance of getting stronger and getting back to the activities you want to do.
A lot of these progressions will follow the same principles as the strength training progressions mentioned earlier.
Start with 2 limbs instead of 1
Start with body weight or assisted
Start with low impact
A progression for the lower body from easy to hard could look like this:
Band Assisted pogo hops
Body weight pogo hops
Weighted jumps
Single leg hops
Depth jumps
If you’re new to plyometrics entirely, it’s important to incorporate them appropriately, especially when dealing with a tendon issue at the same time. Make sure you’re ready for it, and start light and easy, letting your body adapt to it.
FINAL THOUGHTS
Remember, no strain, no gain when it comes to tendons, but you need to be smart about it as well.
Loading and working the tendons is absolutely crucial when it comes to strengthening them and being able to do the things you want to do pain-free.
You want to start off by adding isometrics into your routine, then eventually progress to heavy strength training, and then when tolerated, throw in some plyometrics into the mix.
If you’re dealing with tendon pain that’s interfering with your day to day, and you don’t know what to do about it, reach out today!
Our goal at Delta Kinesiology is to help women reach their health and fitness goals
regardless of age, ability, or experience level.
We tailor each session using evidence-based principles and methods to help you reach your goals. Whether that be going about your day pain-free, building muscle (and tendons), improving stamina, or feeling better about yourself, we are here to help.
Get in touch with us today to schedule a free consult by clicking the link below.
References
Rio, E., Kidgell, D., Purdam, C., Gaida, J., Moseley, G. L., Pearce, A. J., & Cook, J. (2015). Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. British journal of sports medicine, 49(19), 1277–1283. https://doi.org/10.1136/bjsports-2014-094386
Bohm, S., Mersmann, F., & Arampatzis, A. (2015). Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults. Sports medicine - open, 1(1), 7. https://doi.org/10.1186/s40798-015-0009-9
Arampatzis, A., Mersmann, F., & Bohm, S. (2020). Individualized Muscle-Tendon Assessment and Training. Frontiers in physiology, 11, 723. https://doi.org/10.3389/fphys.2020.00723
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