Exercise Prescription In Tendinopathies Flashcards
Who is concerned by tendinopathy ?
- People > 40yo
- Athletics population (tennis, volleyball, basketball)
What’s the main key in tendon & tendinopathy?
Load -> unload or excessive load can lead to Stress shielded => Ractive tendinopathy => tendon dyspepair => degenerative tendinopathy if the load is not changed to an appropriate.
How to strengthen the tendon?
Apply an appropriate load
What’s a reactive tendinopathy & when can it occur?
= Non-inflammatory proliferative response
• In response to acute overload : unaccustomed PA
• Can occur to direct blow (trauma) -> compressive load
What happens during tendon dysrespair?
-Incr. cells
- Separation of collagen & disorganization of matrix
- Incr. vascularity
What’s a tendon dysrespair ?
= Attempt at tendon healing
- Chronically overload younger tendons, or result of age
- Can be reverse w/ load management
What can we observe in a degenerative tendon? (Micro)
- Matrix & cell changes + disorganization
- areas of cell death
Is a degenerative tendon state reversible?
Not really, there’s a very little ability to reverse those degenerative changes
Who is concerned by a degenerative tendon?
- Middle age athlete ++
How to treat during a reactive phase/early tendon dysrespair?
- Reduce load/ adjust periods (don’t stop sport!)
- Idenify the potential bio mechanical overload source
- Rest period (at days 3 bcause it’s the type 1 collagen peak)
How to treat during a late tendon dysrespair/degenerative
- Stimulate cell activity -> Incr. protein production & restructure the matrix
- Impr. tendon structure w/ Eccentric ex
What’s the effect of Eccentric exercise on late tendon dysrespair/degenerative?
- Reduce pain within 4/6 weeks
- Improve tendon structure (bcause of lengthening)
-> Pain can still be up to 5/10 NPRS even at 4/6 weeks treatment
