As the winter months slowly start to take over our skies, the balmy holidays in July and August already feel like a distant memory; what that also means for a lot of us is that we’re back in full swing with our gym routines, running trails, contact sport training and games – casual and professional athletes alike – and perhaps preparing for our next marathon/half-marathon.
Interestingly, we as Sports Physios tend to see an upward surge in sports injuries around this time of the year. And sometimes, as a figure of speech, we can even predict certain months being more “hip/knee/ankle injury dominant”, depending on whether there is a prominent sports events coming up e.g. London Marathon, or a finals series. In those months, we are bound to see and treat a few people with sore ankle tendons or painful knee tendons.
…but why is that?
Today I’m hoping to provide you with a little insight to how we as physios answer that question.
Tendons mostly are the thick, fibrous connective tissue that links a particular muscle to a bone, and is the main structure that converts a muscle contraction into an actual body movement. It is primarily made up of collagen tissue, and this tissue can be an incredibly robust, “workhorse” structure – being able to absorb impact, withstand multi-directional forces, convert muscle energy into movement, and generate power + velocity pertaining to our chosen sport.
However, tendons do have a major character flaw: they are very, very sensitive to change. Which means any drastic changes to one’s training routine – simply termed as Load in Sports Science – can have an irritating effect on the tendon structure, eventually leading to pain. Load, as we know, can be measured in a few ways:
- Frequency: How often the training takes place e.g. How many runs per week?
- Intensity: How hard the training session(s) is, e.g. How fast you’re running
- Volume: How much the person is doing in a particular session, e.g. How far you’re running
When there is a sudden, drastic increase in load – or an “upward spike” – the collagen structure of the tendon is unable to cope with these changes, and can often begin an inflammatory process, leading to collagen/tendon breakdown, and in severe cases, loss of structural integrity. Broadly speaking, this is when the person begins to feel a persistent pain during and/or after the training, and the performance/output is no longer as well as before. Conversely, tendons also adapt to a decrease in load – or we refer to as “deloading” – whereby the collagen structure adapts to a lesser training load/regime, and in time is no longer at the capacity of its previous training intensity. So if we were to put two and two together: a deloading phase during our summer holidays/off-season followed by an upward spike around this time of the year…it’s not hard to see why some of us are getting aches and pains!
Luckily, most of the time these changes are not permanent, and tendons generally do respond well to treatment and rehabilitation. This is where the expertise of your physio comes in – we can determine the extent/severity of your presenting tendon injury, provide any immediate treatment that is necessary, but more importantly go through the details of your training routine and carefully making adjustments to it. This ensures that we are gradually rebuilding your tendon strength properly, as well as preventing it from further irritation and breakdown. Such is the nature of tendon injuries, there is no one-size-fits-all, and each case is treated in accordance to its specific needs.
All the physios at Emma James have had the privilege to work with (and currently so) athletes at various levels, and therefore are very experienced in dealing with tendon injuries.
Should you have any doubts about your training, be sure to contact us as we would love to help. Just imagine: us making your marathon training (actually) enjoyable!