Load Management

Written By Emma Murray

Tendon related issues can be challenging and frustrating to manage. The frustration may lay in outdated treatment approaches and/or in not managing the external and internal forces or “load” that is being applied to the tendon. This continual mismatch of load i.e. over or under-loading without tissue adaptation can lead to ongoing dysfunction, pain and frustration.
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Tendons have long been associated with the suffix “itis” Latin for meaning inflammation. Which most of the time leads to icing, anti-inflammatories and rest. If that’s the treatment your tendon is receiving, I’m sorry my friend you are going nowhere anytime fast… no pun intended. Indeed, tendon related issues have been shown to have an underlying “inflammatory” process but not of the traditional sense. However, resting your tendon will lead to under-loading a very important structure that needs to be appropriately loaded.
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Did you know that gluteal tendinopathies are the most common reported lower limb tendinopathy? Like any injury there are a lot of underlying factors that may predispose an individual to tendon related injuries; some may be modifiable some may not. However, the challenge is understanding the ones that we can change and sometimes they may be unbeknown.
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Now this is not to increase fear or to make you hypervigilant – but sometimes habitual loading patterns such as standing ‘hanging’ off your hip, constantly crossing legs and walking like you’re on the ‘catwalk’ (dropping the hip) is also load and inappropriate load transfer is happening to the tendon which is weakening the muscle/ tendon and leading to protective changes such a bursal thickening or “bursitis” to manage the compression forces.
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Now, one of the most important components is getting the “load” right – how much is too much and how often is too often? As I mentioned it’s “grey”, however have this chat with your physio to help manage your load as everyone is individual and get that ball rolling again; it’s not all doom and gloom.