Your knee (or any other joint) hurts; it’s been hurting for months.
At first, you tried to push through the pain, but every time you tried hiking, running, playing a sport, or doing yard work for a few hours, it got angry and left you limping.
Then you thought you had a breakthrough. It stopped hurting while you were active, so you started going hard to make up for lost time, only to find out that even though your knee doesn’t hurt while you’re exercising, it hurts even worse after finishing.
Feeling defeated, you decided to throw in the towel and rest it for a few months. It’s been three months, but it still leaves you laid up for two or three days every time you try to go for a jog or squat in the gym.
You’re starting to wonder if it’ll be like this forever…
You’re not alone; we’ve seen this scenario literally thousands of times.
It’s a condition called degenerative tendinopathy, which sounds scary, we know, but it’s not as intimidating as it sounds.
Let us walk you through it.
Degenerative tendinopathy starts as regular old tendonitis (aka reactive tendinopathy). This happens when your tendons don’t have enough time to recover, so they get inflamed and angry when you’re active.
If tendon pain gets worse with activity, the prescription is to rest.
Your body needs time to catch up and heal those tissues. Tendons have poor blood flow, so they heal slower than muscles which is why it’s so easy to end up with overuse injuries of the tendons.
When you don’t rest, it evolves into degenerative tendinopathy.
You can think of it this way; the tendon becomes overwhelmed with chronic inflammation, and because blood flow is so poor, the individual fibers within the tendon become disorganized and weak.
In this case, it feels better to move, but it often feels significantly worse after you’re done exercising.
Here the prescription is movement, BUT it’s essential to do the right kinds of movement; otherwise, you’ll end up making things worse.
Things that will make it worse are repetitive cyclical movements like running, jumping, and bounding; think anything with a bouncy or springy motion.
What’s the right kind of movement?
We use heavy, slow resistance.
That means we want you moving with weights about 8/10 for difficulty at a slow tempo.
That could look something like a back squat or even a leg press with a weight that’s 8/10 for difficulty moving at a tempo that’s 3 seconds down and 3 seconds up on every rep within a range of motion that keeps symptoms at a 4/10 or less.
Why does this work?
Spending time under tension is how we get around the poor blood flow issue. It allows the tendons to heal by absorbing nutrients and making it easier for the fibers to be reorganized.
If this sounds like you, you don’t need more rest; you need to get moving and load it up.