“10 minutes for your tendon”. Thoughts from Graham Anderson at the Australian Open Tennis

“10 minutes for your tendon”

Thoughts from Graham Anderson at the Australian Open Tennis on Day 9:

“Tendinopathies of the achilles and patella tendon are common place. An injury of the Achilles tendon is a degenerative condition of the tendon. The injury is caused by chronic repetitive movements during running and jumping with inadequate recovery practices. It occurs mainly in recreational tennis players aged between 35 and 45. The symptoms are a gradual increase of pain, initially only in the morning and at the start of the training. In later stages, the pain may be continually present during exercise. The pain is usually felt in the Achilles tendon, 5-7 cm above the heel. Continued tennis carries the risk of a gradual worsening of the injury, which makes recovery more difficult.

If you identify the injury in the early stages (reactive tendinopathy or early tendon dysrepair) then load management/reduction will allow the tendon time to adapt and recover. This will results in lower levels of pain. Exercise, in association of some soft tissue work is the most beneficial treatment option.  Historically, eccentric exercises have been commonly prescribed over the last decade, following the pain-provoking Alfredson programme of 3 x 15 reps, twice/day.  Sometimes, it still works very well. In these stages if aggravating activities are continued and eccentric exercises are added without sufficient recovery, poorer outcomes will result. In degenerative stages exercise appears to be a positive stimulus for tendon restructuring.

Recent research favours isometric exercise as an initial treatment – partly because of personal experience with Achilles, patellar, and lateral elbow tendon issues, & recommendation from Jill Cook & Craig Purdham from Australia. Their research protocol uses 5 reps of a 45 second contraction, at a 70% effort. I like a larger total volume of at least 10 minutes/day.  Obviously it’s hard to define what the perfect dosage is for exercise, & volume could be adjusted depending on results.”