The Key to Building Strong Tendons | The Science of Tendon Training
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- เผยแพร่เมื่อ 22 มิ.ย. 2024
- How to Build Strong Tendons | The Science of Tendon Training
Which approach would you take to building the achilles tendon?
Strategy Number 1:
Pogo hops 20 seconds 4 sets
3 x 15 standing calf raises
3 x 10 bent knee calf raise
Maybe some soft tissue work
This is a very common protocol in Physical Therapy.
Strategy Number 2:
5 x 5 slow controlled resistance heavy calf raise (3 seconds up, 3 seconds down)
6 x 8 second high load standing calf raise hold
Training strategy number 1 likely isn’t moving the needle on tendon properties.
We know from research (linked below) that moderate loads taken to fatigue are effective for building muscle strength but show little to no benefit to building tendon stiffness.
Tendon stiffness can be thought of as the resilience of the tendon.
The key to building strong, robust tendons is long enough contractions to deliver high load through the tendon (3 seconds +)
Are isometrics or heavy slow resistance better for building tendon properties?
Both can be equally effective. It just comes down to delivering high load through the tendon.
Important Note: In the case of an injury, we need an entry point of loading. That may be bodyweight or even seated calf raises. The key is to be progressive through. We're not moving the needle on tendon properties with those low loads just reducing the irritation and we need to progress to higher loaded movements to build a strong, robust tendon.
I see people telling me they’ve had recurrent tendon injuries off and on for a year or more. This is particularly common with achilles tendinopathy and poor rehab plans that don't reach meaningful loads are often responsible for the poor outcomes.
Recurrent tendon pain may be a sign of underloading the tissue. Don’t get me wrong you’re doing plenty of reps. You can tell me "Oh but I’m doing my HEP" I believe you. It’s just not moving the needle on tendon properties.
Let’s talk about the knee tendons.
A starting point can involve longer duration isometrics like spanish squats or wall sits to start to deliver safe, well tolerated loads through the tendon.
Over time we want to deliver higher loads to the patellar tendon.
We can do this with more weight or in the case of the knee by advancing the knee over the toes.
Yup, knees over toes guy is onto something.
Hack squats and knees over toes split squats are examples of exercises that advance the knees over the toes.
You can apply this principle of loading to different areas of the body.
Find an entry point to loading but also work to target an exit point that is challenging enough to improve tendon properties.
Plyometrics for tendon strength:
Plyometric training is more specific to building tendon extensibility.
We want to be progressive with volume and use these alongside higher loaded movements.
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Coach, Consult these exercises are the ones that will help me increase my vertical jump?
@@TwitchElCapi To increase your vertical jump follow this video: th-cam.com/video/1CFAZfxEkoQ/w-d-xo.html
I'm having gluteal tendinopathy since a year ,started isometric from 4 months ,how to proceed .
Another amazing video! As always! Thnx for the info and keep up the good work my friend!! 🙏
Sir, you are delivering very valuable content here! Thx
Nice video! You touched briefly on a concept that I don't think is discussed enough in the Kneesovertoes world and that's the fact that the progression itself could be how much the knee is going over the toe rather than progressing only through external load. A slow shift from a more hip dominant to knee dominant squad is a great way to ease into Kneesovertoes training rather than hopping straight into end range training and having to regress to assisted bodyweight.
Great channel man! Very impressive and informative.
Real expertise! Many thanks.
Super helpful video Matt!!
This is so good and so important!
Thank you for shedding light on such an important loading aproach. But i think, there is a progression: from light iso to heavy, then to regular exercises (that is speeded up over time) and then to plyos(from low level to intensive ones). And may be it's reasonable to remain some exercises from a previous level staying on the next one
Very informative. Thanks.
This was super helpful!
Thank you very much! I recently finished Physical Therapy for Achilles Tendonitis and was looking to further strengthen my Achilles. Had I not seen your video, I would continue with just bodyweight work. I'm ready to add weight and hopefully will continue to get stronger.
Nice! That's exactly why I made this video
Thank you for these videos. I am on my 9th month coming from an ACL/meniscus partial tear, and I feel actually being educated and informed on how the body works makes me motivated and appreciate taking care of myself more. I definitely feel stronger than I did before my injury.
x
Me too
Taking care of yourself...❤
How’s your injury now?
Thanks for sharing 🙏🏾
Highly informative. Subscribed !
Welcome aboard!
Love me song research based content, this one's going in the playlist, thanks!
Great. Thanks.
Please give me examples of exercises for shoulders on building tendon strength. Great information as always!
Discussing the Schoenfeld study, you equate strength with stiffness. But these are actually two different properties.
Yeah. I've listened to Keith Barr and he make following distinction: Slow HEAVY movement, even isometric, makes tendon resilient but as a result tendon looses it's stiff properties, so tendons doesn't transmit force as fast from muscle to bone as well. Snappy movements do the opposite and makes tendon far more prone to injuries while improving ability to run and jump.
Another is for injury recovery and another for athletic performance.
Not that any of this goes against what was said in the video, i just don't like the word strength being used here. But with that said there doesn't seem to be correct terminology to be used. Some don't like word stiffness either as it gives wrong connotations as well.
I've been doing tendon exercises the past two weeks and isometrics. This apparently isn't enough time to build tendons but I'm far more rigid and explosive. I finish up lifting with weighted stretches. All of these activities would reduce tightness in muscles and tendons and increase their total range of motion.
Maybe "small range of motion" is what's inferred by tight muscles are better for "whatever". If you have a smaller range of motion for a specific activity it might be ideal and faster but dangerous.
I just thought of this on the fly. Let me know what you think 🤔
@Second247 so what do we do then ? We don't want injuries and we want strong tendons
@@Second247 as a sprinter i do both
@@aaqe92837 both , long isometric for tendon health/stifness , short heavy isometric , then slow eccentric. After that plyos
For exemple , standing calves isometric for about 1 minutes for the long isometric
Then standing calves isometric but with weight that you can hold only for like 15s
Then heavy eccentric , low reps like only 4-5 , while controling the eccentric for about 4 sec
At the end plyos , for exemple pogo jumps or depth jumps
Amazing stuff as usual. I'm dealing with patellar tendonitis and you just made realize that I need to go heavier to stimulate my tendons more.
Yes. Just be sure to do so progressively
I actually had good knees and decided i wanted to make them stronger, so i started reverse sledding on a pretty stubborn treadmill, stacked with atg split squats. I now have mild patellar tendonitis. You absolutely can build strong tendons without heavy load; this video confuses stiffness with strength. Start by walking backwards on a treadmill until you feel little to no pain in your knees and then start using more than bodyweight; absolutely finish the base steps first, dont make the same mistake I did of overworking my knees
@@hanjiplayer yeah this video is literally only beneficial for sprinting/jumping. That is the only scenario in which you want stiffness. low loads are great for strength and injury prevention. this only benefits explosiveness
@@emmanuelalagbala9590I think it's hard to make one video that satisfies everyone..
@@hanjiplayerCan u detail your recovery plan? Had patella tendinitis for 6 months has gone away. Started to stop playing sports now.
My plan is to incorporate slow heavy strength exercises to increase the load on tendons paired with plyometric kind of exercises for more explosive power. Also adding very high rep low intensity exercises and Isometric holds to pump blood into the joints to promote recovery. I am hoping these ideas will help my tendons, ligaments and joints.
Cool, sounds like a contrast method
As an explosive athlete I want to do the same. I wonder what order I should do these in in a day. I’m thinking things like sprints or plyometrics and then the eccentrics/isometrics. Seems like the natural order to me, what did you do or think?
@@natemajor6560 I think that makes sense. I would do sprints or plyometrics first, the more explosive type exercise first, followed by strength work. I personally like doing some light isometric holds first though as part of a warm up too, makes my joints feel a little better.
Heyya, thanks a bunch for all these videos. Super helpful and informative.
Curious: Have you ever trained hypermobile athletes (I am one), and I'm 'wondering how you'd go about doing that. My current physical trainer has no experience with it
Thanks!
Very interesting, as an ultra runner logging 75 trail miles a week at 46, I'm always concerned about potential ligament injuries. I do 2 leg workouts a week targeting glutes, quads, hamstrings and calves for durability but I will definitely incorporate spilt squats
on slant board and heavier calve raises.
yes, but remember why. the key takeaway is that it is from heavy, slow, holding poses putting the tendons under pressure
Great video! Thanks. Could you do a video for wrist &elbow tendons please?
Helpful video and thorough explanations. Do you recommend to heavy load the IT band during or following IT band rehab? If so, what excersises do you recommend to progressively load the IT band? Thanks in advance.
Always been interested in seeing how I can strengthen the elbow flexor tendons. How do you balance a properly heavy load with enough range of motion? Some exercises like preacher curls can put a ton of stress on the tendons.
thank you Matt for all the good info, any recent papers you can recommend me for shoulder tendons strenght and rehab? thank you in advance
I’ve been doing very heavy farmers walk and that has tremendously helped me with my tendinitis.
Nice
Where on the body is your tendinitis?
@@kaidavies2604 left arm. Tennis elbow has been a factor in my training for a while.
@@BigMo0212 thats what i have. Demoralising my training atm. Ill bring farmers walks into it 👍
Great video. How many sets per workout and how many times a week would you recommend? Also will this work for the tendons in the upper body? Any light you could provide would be greatly appreciated.
Fantastic video. Great content. What are the best current guidelines for how rapidly a patient should increase load weight and volume?
Good question, I wouldn't mind knowing this too.
Hey Dr. Matt, thanks for these great vids. If possible, I would love to get your opinion on frequency of training the tendons. I do sprint training 2-3 days/week, with at least one (usually two) of those days being a 100% effort session. And I'm curious if incorporating either slow, heavy resisted calf raises (5x5) or heavy iso calf holds just once per week would be enough training volume to effectively make the achilles tendon stronger, or would you recommend another protocol? Thank you
I started doing this sort of thing for my rotator cuffs to bulletproof the shoulders. Slow eccentric reps are essential. You’re absolutely right about the load. There are studies as well about it stimulating collagen production in the tendon as well to promote healing and strength. As a pta they didn’t teach this specific info in school. I Got a lot of this info from the book “built from broken”.
Thank you. Exactly what I was looking for.
Please do a video on elbow tendons, Mahalo!
Thanks. Great content. Can u advise how often should we train this way? 2-3 times per week or shold we organize our training program based on feeling in training area?
Thanks for the video. What frequency would you recommend for strengthening the knee?
Going down steps hurts my right knee, yet, I have no problem doing squats or burpees or even lunges. Cycling is no problem.
But I can't run without pain immediately. Also going down steps can quickly hurt.
I want to try and fix this without surgery. Any recommendations are appreciated. Thanks.
Can't
Please make a video about how to build strong tendons for string and piano musicians, the community need this.
dont know if its exactly what youre looking for but the squeezing rice in a bucket exercise helped me build a lot of finger and wrist strength, targets the smaller muscles
The shoulder and elbow ligament video please and thanks
Thank you Matt for this great vid. If I wanted to do plyometrics for Achilles rehab, would you recommend doing them before or after 5 x 5 heavy slow resistance session? Or is it best to do them on a separate day?
Early on in rehab I typically would do them on the same day and train 3x per week. Then later on once you can handle more than 3x per week if you want to you can progress to alternating between heavy days and plyo days
Quality work here, shared it with the homies
Edit: question - how would you incorporate this into a typical hypertrophy based program, assuming there are tendons we’d like to focus on? Just add some of this work at the end?
I would add it at the start. For example 2-4 sets of short duration high load isometrics. Not very fatiguing since there’s no lengthening under load and could actually have a slight potentiation effect for your hypertrophy work. A little bit of volume goes a long way with these high load moves.
Great info Matt! Can we generalize this approach to other tendons of our body? For example the rotator cuff tendons??
Thank you
Sort of. The rotator cuff is a bit different because sometimes high loads lead to bigger muscles taking over the Movement
How about shoulder tendon strength training would be informative. Thank you.
Great videos. Do you have one concerning elbows, specifically golfers elbow derived from doing pull ups? I've only been working on them for a year but it's been a constant battle from tolerating pain to taking breaks to let my elbows heal up. Thanks.
Should we do this before or after the standard weightlifting hypertrophy/strength workout?
Or should we do this in a different time of the day? Like weightlifting in the morning and tendon workout at night or something?
How many times a week should we train the same tendon?
Your content on tendon strengthening is fantastic; bravo.
I am currently recovering from long-standing adductor tendon pain (over 5 years). I am currently doing mostly isometric exercises (weeks 0-4). However, I am still experiencing pain in the tendon. Once this pain alleviates, I will add more eccentric exercises to my program. Lastly, I will add heavier loads into the tendon through weights and cable machines. How does this plan sound to you? Any tips?
@The Movement System Since I've started Muay Thai, I've been having issues with shin splints and just recovered from a stress fracture in my left foot. About 8 years ago, I got stress fractures in both of my feet when I started running, but was not using good running shoes. I've been told I have depleted arches and now wear special insoles daily. The issues I'm currently dealing with are all occurring my conditioning though, and not necessarily the fighting, primarily on the speed rope and jump squats etc. I don't really have the option to do different exercises as we function as a whole group. Are there any special stretches or anything specifically you could recommend to help prevent further issues? Or is it just going to take time to let everything get stronger and recover properly? I feel like when I get the shin splints and then I just take two weeks off to recover, it just restarts the process.
Very helpful. Any tricks up your sleeve in re targeting shoulders? Thanks!
I need to make a shoulder video soon. There are some different considerations since stability is a large function of the rotator cuff musculature. Also they are smaller muscles and tendons so you have to be precise about how you deliver load or else larger superficial muscles will take over.
Could you talk more about the tendons and ligaments in the arms along with the tendons in the back and chest please
Can you do a video on a what a full rehab program would look like for athlete that needs to train throughout the rehab. Example still needing to squat while doing rehab.
Thank you so much for this video. When I do any kind of squat movement, knees over toes... My knees pop. They don't hurt, but they do make a lot of noise when I go all the way butt to the floor. Is this bad, or should I be concerned? Is there a way to keep them from popping if it is not good for me?
Yesssss matt new haircut 🤤🤤
Thank you!
Can you plz do a video on shoulder tendinitis?
Please a routine for the cuadricipital tendonds (knee joint)
Wish I had heard this sooner. I have a posterior tendon tear or rupture of right ankle/ right lateral calf. Can't afford surgery at the moment really. Bummer
I just realized that complimenting my weightlifting workouts with pilates and yoga, I do all those explained movements to build strong tendons. I highly recommend pilates and yoga to any bodybuilder for stronger tendons, longer muscles, a powerful core, and stretching purposes.
hi, please could you give any advice on strengthening the supraspinatus tendon? thanks for any ideas 🙂
Could you do a program for building knee tendon strength
How do you incorporate this type of training with regular strength training? For instance, do you add these exercises to your normal leg day routine or should it be separate? Or should you only train tendons for a period of time and then switch back to regular strength training?
high loads longer but fewer reps actually makes a lot of sense.. because the focus would be on maintaining the position rather than moving through it. the longer you need to maintain a position the more your tendons would get involved as the main muscle group seeks support from muscle groups nearby and that involves the tendon more. i'm probably medically wrong but makes sense to me somehow
Very good video! I have a question: Probably after (normal) supinated bicep curls, I have pain in my wrist at the little finger (it goes a few inches in the direction of the elbow on the outside of the lower arm starting at the wrist) when I rotate my hand with the fingers stretched (in particular when pronating), and in a handshake when I turn the hand down in the direction of the little finger and use force to squeeze. I'm sure a tendon is causing the pain.
Can I do certain exercises to help the tendon heal?
Will grip exercises help by increasing blood flow in the wrist?
Is it a bad idea to do a static hold, i.e., trying to supinate/pronate aginst something fixed?
Or maybe something else?
I'm not a doctor 😂 but maybe you have some carpel tunnel issues?
Is the posterior tibialis tendon similar to Achilles in terms of progressions and exercises? Other than band work that targets that muscle and tendon, a lot of the other exercises my PT has me doing are similar to Achilles rehab exercises.
Thanks for your info and analysis. I am in physical therapy to address what is typically called golfers elbow stemming from a weightlifting tendon injury and wonder if you think one should - for example - do heavy dumbbell farmer carry loads for 30 seconds to a minute while being careful to not exceed a 50 percent pain threshold? Any other thoughts are welcome and thanks for your videos!
The progressive part of knees over toes is really crucial and something KOT guy doesn't stress enough. Glad you mentioned him and doing KOT squats bc I went straight into his stuff thinking I could surely do the full range of motion in the split squat with knees past the toes and it turned out I couldn't. I am still recovering from the patellar tendon tear I got due to it a year later. I'm just 30. This is probably why people thought for so long that it's unsafe. It actually can be. You just don't have anywhere near the load tolerance in those tendons if you haven't been using them compared to your muscles for squats and lunges. Doesn't matter if you can squat 10x200lbs. If you haven't done knees over toes in years, or decades, start on a chair. Start way easier than you think. You're not working your muscles, you're working your tendons. They can't handle the heavy and quick movements yet.
He definitely mentions the progressions, sometimes in the shorts as well.
I am a PTA, I play disc golf. I noticed that there is a new goal injury called tricep tendinopathy. It is typically with players that trying to throw really far. What are exercises that you would suggest for improving loading the tricep tendon
Do you have any ideas on how to apply this to posterior tibial tendinitis? My pain is on the lower tibia (above the ankle bone), and I’ve been unable to find a way to apply a heavy, slow load to the tendon.
I haven’t been able to find an
anything abotu hip flexor tendonitis? Multiple hip surgeries and leg and I'm left with tough set in pains. Looking for answers? Thanks. The concept of additional loading for tendons beyond what would work for the muscles is new to me. Good Good,
Would You consider an Overcoming Isometric contraction for time a good method for applying high loads through the tendons?
Yes
how do i manage track practices and rehab? i am trying to find a good balance so i can tackle my patellar tendonitis
Best way to place heavy loads on the lateral elbow for tennis elbow? And would you still work from 5 reps and build to 10 etc?
Hi. I’m dealing with recurring wrist and elbow tendinitis. With all the PT’s I’ve seen it’s always light weight, higher reps. Do you recommend any specific ex’s for this?
A point: No one can build anything without having the wherewithal present. Please touch on the nutritional elements that will enable the body to construct stronger connective tissue after these load challenges.
With plyometrics and stuff like that you said it would be beneficial to do it with the high load exercises to strengthen tendons, would you do both of these things in one training session?
I’m wondering what order I would need to do these in a training session as well
I have pain in the left side of the left calf if I sit for a long time. And my doctor didn't have much clue. Would these exercises help with that?
does doing isometric with leg extension machine works for strengthening knees tendon??
are there any exercises we can do to focus strengthening the acl and the mcl ?
Can you get "sored" in your Tendon when exercising for it (clearly yes) but is it the same stimulus like when your train for muscle growth?
To clarify: I started training for my patella tendon in my knee and got always like for the next max. 2 days after the workout a really shallow pressuring soreness in my knee which disappeared then after I recovered. I just started out with knee over toe exercises so Im careful and don't wanna rush through the progressions.
Im just wandering if a little soreness in your tendon is a good sign that you stimulated the tendon for getting stronger, Or is it like tendons shouldn't hurt whatsoever and that when theyre hurt its a sign that I destabilized the tendon by pushing the gears to hard.
Hope you understand my question.
Thank you anyways for that informative video!
Would you please address how to adapt heavy slow resistance training to posterior tibialis tendinopathy?
Omg man, dealing with the same horrible problem here
I guess heavy single leg calf raises and seated soleus raises
Great video! I think you're right about data catching up with main stream treatment. But my questions is about insertional achilles tendinopathy? Do you think starting with a high load isometric, such as a calf raise with 35lb weight and standing on one toe for 3 sets 30 seconds each is a good place to start? I've been doing calf raises now for over a year but had very little progress. Both insertional achilles have tendonitis, worse in the left. Every time I ramp up my training I always irritate the back of my heels. Its maddening some times. Any thoughts are appreciated.
I would be progressive about it. You could try gradually reducing the volume of repetitions you’re doing and ramping up the load. Just add 5-10% to the load you’re doing now every week or so until you can just barely complete full repetitions.
@@TheMovementSystem I'll give it a try and let you know how it progresses. Probably post in about 4 weeks. Thanks for the follow up.
changing the toe angle helped me get past a point where rehab stagnated. - do a set straiught, toes out, toes in. I do ISOS st start then finish with slow reps, heel never touching the floor
is there a joint angle that is optimal for isometrics or do you just go for mid range?
What do you think about the horse stance from karate and kung fu for building tendon strength?
If I’m an ultramarathon runner who’s tendons basically get inflamed around mile 70, which strategy is best for me? Both anterior tibial tendons and the patellar tendons all flamed up on me in the last race and I really want to armor them. Ultra Science Podcast on the subject recommended 6 minutes of jump rope at least 6 hours before or after a run. Was debating adding in some of the heavy lifting stuff you mentioned but wasn’t sure… thoughts? My tendons are solid for over 50-60 miles… just trying to be able to keep running further as my tendons go before my muscles and cardiovascular system goes
I've been having tendon pain in my hip, and I'd like to ask how to safely target that area.
Do you recommend heavy kettlebell tippy toe farmer walks for achilles tendon growth?
Were i am confused is, if i already have tendonitis (which i do in the patellar tendon in my right knee and in my elbow) if i have to strengthen them with load, should i be waiting for it to heal completely first? Or should i be doing some exercise during the healing process, just at a reduced load and volume? I had been increasing the weight gradually on my hack squats, and doing some negative chin ups, just getting back into exercising. But obviously failed to take into account that my tendons didn't get stronger in pace with the muscles.
What type of exercises you would recommend to load a forearm common extensor tendon to help with recovery from a tear?
Holding a hammer and rotating the wrist. (Flexion, extension, pronation, supination)
Question: Would you recommend these heavy load sets on the tendon before or after a workout? Example: If I were trying to grow strength in a weak biceps tendon, should I do this before or after a back/bicep workout?
I think either way is fine
Are old school lockouts considered tendon building? That is when you are in a power cage and lets say bench a very heavy barbell up to 2" and hold it. Also will this work with squats too? Thanks
Any ACL recommendations?
How do I include exercises for upper body tendons strengthening. Specifically, major and minor pectoral tendons with the shoulder.
Is there a good exercise for improving the tendons in the hamstring?
Do you have tendon exercises for golfers elbow
Would pressing your feet against the foot plate during Nordic curls (3×5-10) work the Achilles tendon?
@the Movement System how do i strengthen my bicep tendon
How do i build patella tendons ? 🙏
suggestions on building /(rebuilding) adductor tendons. Seems like taking FOREVER (weeks-months) to slowly get adductor tendon insertion near pubic bone to heal... muscles fine just tendon... any suggestions beyond patience and slow graduated tolerance to exercises?
Does this also apply to ligaments?
What would you do for hips? My son dislocated his hip in football 1.5 years ago. He still has some random pain. We need to bullet proof his hips before thinking about football again.
What about tendons regarding arms? I'm into armwrestling a little bit, how to make tem stronger?
Hello fellow MD. Could you give some advice to a fellow md. point some ways for pectoral muscle tendon? Emergency medice doc here, calistenics guy, kinda injured my pec tendon lately while doing navy seals... Any tips will be highly appreciated.🙏
How long does gluteal tendinopathy take to heal