There is something about the isometric load that is somehow better than isotonic. I use to be in excruciating insertional Achille tendon pain for years. After driving a manual car for a few months where at intersection, i would press the clutch and hold it in until the light turned green, that cured my Achille tendon 70 to 80% where i can walk without limping. Btw, this wasn't intended as a rehab, a simple habit rehabbed my Achille tendon.
Isometric holds with 48 hrs rest between sessions was the only way Ive been able to start to heal my really really bad wrist flexor tendinopathy. (I used to wrist curl 50kg, was reduced to only 3kg with bad pain for months). Now I'm finally at 10kg holds
@@vadesnow3675 From my research so far, it seems as if your tendons will let you know 24 hours or so later if it's aggravated or not. For me personally, I will know the next day. 48 hours could be that sweet spot for this individual, and in my opinion sounds like a good rest zone. In my own personal recovery, I like to do 2x a week, to ensure 72 hours or more. You will have to do trial and error, and I greatly suggest writing it all down, as if you are writing a log book for gym progress.
For those of you who was very sedentary (like me sitting at home coding and playing games) and then went to the gym and started doing stupid things (with high weight and many sets) and got tendinopathy, then 45 seconds x 5 sets x 3 times per day may be too much for your very reactive (untrained) tendons. It's better to start slowly. For example 2 sets x 20 seconds (once a day) and monitor your resting pain level after 24 hours, if it is ok, then do 2 sets x 20 seconds again and wait for next day. If your pain level is below than 4/10, then you can add 10 seconds for each set, so next day do 3 x 30 seconds and monitor your pain. Add 1 more set if the pain is ok, so 4 x 30 seconds. Then 5 x 30 seconds, then 5 x 40 seconds, then 5 x 40 seconds in the morning and 2 x 40 seconds in the evening. It takes some time to gradually build tendon capacity from 2 x 20 seconds (once a day) to 5 x 40 seconds (twice a day). 2-3 weeks maybe. But if you are a runner or athlete and you were well trained before you got the tendinopathy, then you can start more aggressive like 5 x 45 seconds and it will be ok for your tendons.
Валентин Иванов she actually says you can go heavy from the start and it should be around 45 seconds. She said 20 seconds is too short to have the effect. Hope youre doing better! 🙂
@@levinsonl Yes, she said. But she already said that your pain level should not increase the day after your isometric. But for untrained individuals (like me) it increases if I do 5x45seconds.
@@wskeal86 Intensity is King! The load sounds too high, not the time of exercise. All things are scalable, but longer isometrics (30-45s) elongate tendons and move more synovial fluid, hence why 25s may not be as ideal.
I am currently dealing with an issue with my right distal bicep tendon, it has been sore for the past two months. My physiotherapist directed me towards stretches and light eccentric bicep curls. I have overdone these - and had a few set backs. My fault. The last two days I attempted and conducted isometric exercise - 45lbs barbell on a power rack allowing a 90 degree at elbow, forearm, and upper arm. The pain has disappeared in day three. I will continue to progress with set and time. Eventually work in eccentric exercise in the coming weeks.
Genau ! Es ist schon katastrophal sich die neusten Sachstände bei Tendinopathie aus dem Netz auf den englischsprachigen TH-cam Videos zu besorgen um irgendwelche Hilfe zu bekommen 🙈 ! Ich habe mal in einem Kommentar geschrieben das sich unsere Physiotherapeuten noch in der Steinzeit bezüglich der Behandlung von Tendinopathien befinden . Ich habe dadurch fast ein Jahr verloren .
@@thomasromeni8063 ich wurde 6 mal falsch diagnostiziert. Healthcare hier und da aber dafür kriegt man in den USA wenigstens das was man braucht auch wenn man dafür zahlen muss.
Extrem katastrophal die Zustände in Deutschland! Habe selbst unmengen an Fehlern mit Physiothetapeuten und ohne durchgemacht und meine Symptomatik erheblich verschlechtert. Ärzte erzählen was von Dehnen, Zerrung oder da ist nichts. Alles ohne das geringste an Diagnostik. Ich reise jetzt durch das halbe Land um adäquate Hilfe zu bekommen.
I have learned so much. Thanks for your input. First time I understand why I do see many post menopausal woman with great trochanteric bursitis. Well , at least that is one explanation.
So happy to have found this, thank you.. Been struggling now as a Sprinter with high hamstring tendinopathy for the past 18 months.... I have rehabbed, done electric shock therapy, PRP ...almost come back and then irritate it again... I now finally have a Physio loading the iso's now, and we are introducing small plyo's now too. .. I need to check the holds and time though as this is important, as you say.. I am running again now at say 65% speed and its really hard to gauge when you can ramp it up and again how many times a week I load. Continual I take it, forgive me as I still have the last 10 minutes to listen to... Grateful someone understands :))))) Fascinating yet frustrating it all is!
I played basketball and was always a very fast sprinter. Very similar to mine injury now 18 months and i also had a lot of negative MRI, PRP and also impingment test and spinal injection test. For me it started with adductor problems in season preperation and not enough rest before season started in combination with a sitting 10-14 hours a day for many months developing piriformis pain. Nothing helped and after some weeks of rest i felt good but it was always a "trap" once the load was a LITTLE to high trying a comeback or at normal daily activities i fell back for weeks. Sometimes the progress of 1-2 month was erased and it was the most desperate and depressing and painful phase i had. For the last 6 month i completely avoid sitting and uncontrolled load at hamstring and tendon. We must never make the mistake again coming back to early. Like a pro all load tests must be painfree before we go back since sprinting and basketball has very high tendon load. It is sad and i am not sure if i will ever come back or be that explosive. I tried a lot of exercises and watched hundres of hours physio videos but the only thing that helped me slow but steady were a lot of massages at the beginning and now isometrics i now do for some weeks like Purdam said: - th-cam.com/video/hjTk_bfNrUY/w-d-xo.html&t=1280 - physio-pedia.com/Proximal_Hamstring_Tendinopathy - th-cam.com/video/NN5VHGz6DvE/w-d-xo.html
i'm also a sprinter. I know some very good uncommon exercises for the hamstrings. I'm not talkin about RDLs or nordics. The reason for such overload inyuries are almost always compensation patterns. Basically one muscle region does not do it's job so the other must do it and gets inyured.
Great presentation. I would say though that if you just partially tore a tendon, there's no guarantee that you'll be able to do heavy loads or long holds or both even though isometrics seem to be magical. For example, you might only be able to do 2 sets of 10 second holds with 2 lbs after 1 week of rest after injuring your elbow (let's say, golfer elbow). Also, isometrics can cause pain during and after doing them (can be a sign that you did too much if too painful or a sign that it was fine if the pain is not much worse). So, be careful. Less is more. So if you're not sure, do less and less often at first.
The presentation speaks about the tendinooathy in legs but I assume it works for the upper limbs as well? I wonder if you need then the same holding time and load?
I have patela problem for 3 yrs ,one year was ok by the time when I used for 20 min jet stream in jacuzzi ,I can't walk for 3 months ,nothing happened pain scale is very low
Hello. I have two-sided tendinitis and peritendinitis Trochanterica. Have I understood that correctly now that isometric exercises do not reduce the pain from the inflammation, but I can continue to do the isometric exercises because they are best used to heal for trendinides? Greetings from Germany, Thomas.
I was told that the tendon that didn't get enough rest will have nerves an blood vessels grow into the tendon because it's frayed and that isometric exercise will make the muscle dense and desensitize the nerves and blood vessels that grew into it.
I have gluteal tendinopathy and bilateral greater tronchenteric bursitis for past 1.5 yrs,started isometric excercise from 5 months,still in pain,how long will it take to strengthen the tendon and be pain free
How is it not immediately obvious to use unmovable loads as opposed to heavily weighted loads? For example, instead of holding a heavy deadlift in an isometric hold, you could use an unloaded barbell and pull against the safety bars, preventing the bar from moving no matter how hard you pulled. The lag of sports research is glaringly apparent due to the researchers having close to no experience in the gym. Id trust a gym bro than a twig in glasses behind a microscope because the gym bro has tried things to compare. The twig conpares things on paper, but nobody can argue that the majority of things in life turn out to be different than they should have on paper.
I guess the disadvantage of your suggestion as oppose to weighted is that its much harder to measure the intensity so you can't build a progression as meticulously. If you're weighting you can gradually progress increasing the weight each time incrementally but if your pulling its very hard to measure the level of that so each time could be different and its hard to build it up safely.
1 week later Immediate strength and pain relief from doing isometric double leg calf raise holds. This is something my 2 PT have not shown me and something I've been struggling with for the last 10months.
@@Nick-kf3io No problem man. Heavy and Slow is next. Isometric don't help forever. I should've moved on to heavy isotonics 1 month after isometrics or even sooner. I'm now doing plyometrics.
After how long can you do 1) half squat with bouncing 2) half squat and rising ( flexed metatarsals) as at the ballet barre with patellar tendon problem?( adult in their fourties?)
I would remove your over simplified thought on a graphic. Most marathon runners heel strike. Yes, there are different loads on the foot/ankle/LE during heel striking as compared to the midfoot or forefoot.
@@rscranman2002 This is WRONG. They DO NOT heel strike. It just looks like they are heel striking but in fact the last second thy are landing on ball of the feet. and there is NO such thing as midfoot strike. You are either striking on ball or striking on heel.
There is something about the isometric load that is somehow better than isotonic. I use to be in excruciating insertional Achille tendon pain for years. After driving a manual car for a few months where at intersection, i would press the clutch and hold it in until the light turned green, that cured my Achille tendon 70 to 80% where i can walk without limping. Btw, this wasn't intended as a rehab, a simple habit rehabbed my Achille tendon.
Isometric holds with 48 hrs rest between sessions was the only way Ive been able to start to heal my really really bad wrist flexor tendinopathy. (I used to wrist curl 50kg, was reduced to only 3kg with bad pain for months). Now I'm finally at 10kg holds
What is your regimen? 3 sets of 30 second holds every 48 hours? Have you also tried every 24 hours? Or did you find that too much?
@@vadesnow3675 From my research so far, it seems as if your tendons will let you know 24 hours or so later if it's aggravated or not. For me personally, I will know the next day. 48 hours could be that sweet spot for this individual, and in my opinion sounds like a good rest zone.
In my own personal recovery, I like to do 2x a week, to ensure 72 hours or more. You will have to do trial and error, and I greatly suggest writing it all down, as if you are writing a log book for gym progress.
You used to wrist curl 50kg. Eather you are lying or you are a armwrestler :-)
He probably means from a neutral position@@GangdamStyle20
Hey what exercise did u to get better? ive had wrist pain for 1,5 years now, miss the gym...
For those of you who was very sedentary (like me sitting at home coding and playing games) and then went to the gym and started doing stupid things (with high weight and many sets) and got tendinopathy, then 45 seconds x 5 sets x 3 times per day may be too much for your very reactive (untrained) tendons.
It's better to start slowly. For example 2 sets x 20 seconds (once a day) and monitor your resting pain level after 24 hours, if it is ok, then do 2 sets x 20 seconds again and wait for next day. If your pain level is below than 4/10, then you can add 10 seconds for each set, so next day do 3 x 30 seconds and monitor your pain. Add 1 more set if the pain is ok, so 4 x 30 seconds. Then 5 x 30 seconds, then 5 x 40 seconds, then 5 x 40 seconds in the morning and 2 x 40 seconds in the evening.
It takes some time to gradually build tendon capacity from 2 x 20 seconds (once a day) to 5 x 40 seconds (twice a day). 2-3 weeks maybe.
But if you are a runner or athlete and you were well trained before you got the tendinopathy, then you can start more aggressive like 5 x 45 seconds and it will be ok for your tendons.
Валентин Иванов she actually says you can go heavy from the start and it should be around 45 seconds. She said 20 seconds is too short to have the effect. Hope youre doing better! 🙂
@@levinsonl Yes, she said. But she already said that your pain level should not increase the day after your isometric. But for untrained individuals (like me) it increases if I do 5x45seconds.
@@wskeal86 Intensity is King! The load sounds too high, not the time of exercise.
All things are scalable, but longer isometrics (30-45s) elongate tendons and move more synovial fluid, hence why 25s may not be as ideal.
How long did it take for you to heal?
I am currently dealing with an issue with my right distal bicep tendon, it has been sore for the past two months. My physiotherapist directed me towards stretches and light eccentric bicep curls. I have overdone these - and had a few set backs. My fault. The last two days I attempted and conducted isometric exercise - 45lbs barbell on a power rack allowing a 90 degree at elbow, forearm, and upper arm. The pain has disappeared in day three. I will continue to progress with set and time. Eventually work in eccentric exercise in the coming weeks.
Anecdotal...but my Achilles's tendonitis resolved with isometrics. N powered of 1. Great presentation. Cheers from US
Much thanks for posting this. Our german docotors, physoptherapists dont seem to know this.
Genau ! Es ist schon katastrophal sich die neusten Sachstände bei Tendinopathie aus dem Netz auf den englischsprachigen TH-cam Videos zu besorgen um irgendwelche Hilfe zu bekommen 🙈 ! Ich habe mal in einem Kommentar geschrieben das sich unsere Physiotherapeuten noch in der Steinzeit bezüglich der Behandlung von Tendinopathien befinden . Ich habe dadurch fast ein Jahr verloren .
@@thomasromeni8063 ich wurde 6 mal falsch diagnostiziert. Healthcare hier und da aber dafür kriegt man in den USA wenigstens das was man braucht auch wenn man dafür zahlen muss.
Extrem katastrophal die Zustände in Deutschland! Habe selbst unmengen an Fehlern mit Physiothetapeuten und ohne durchgemacht und meine Symptomatik erheblich verschlechtert. Ärzte erzählen was von Dehnen, Zerrung oder da ist nichts. Alles ohne das geringste an Diagnostik. Ich reise jetzt durch das halbe Land um adäquate Hilfe zu bekommen.
I have learned so much. Thanks for your input. First time I understand why I do see many post menopausal woman with great trochanteric bursitis. Well , at least that is one explanation.
Great sermon, thank you!
So happy to have found this, thank you.. Been struggling now as a Sprinter with high hamstring tendinopathy for the past 18 months.... I have rehabbed, done electric shock therapy, PRP ...almost come back and then irritate it again...
I now finally have a Physio loading the iso's now, and we are introducing small plyo's now too. .. I need to check the holds and time though as this is important, as you say.. I am running again now at say 65% speed and its really hard to gauge when you can ramp it up and again how many times a week I load.
Continual I take it, forgive me as I still have the last 10 minutes to listen to... Grateful someone understands :))))) Fascinating yet frustrating it all is!
Looks like the guy named Purdam did a talk on hamstrings at this same conference. Hopefully you saw that and gave it a look as well.
I played basketball and was always a very fast sprinter. Very similar to mine injury now 18 months and i also had a lot of negative MRI, PRP and also impingment test and spinal injection test. For me it started with adductor problems in season preperation and not enough rest before season started in combination with a sitting 10-14 hours a day for many months developing piriformis pain.
Nothing helped and after some weeks of rest i felt good but it was always a "trap" once the load was a LITTLE to high trying a comeback or at normal daily activities i fell back for weeks. Sometimes the progress of 1-2 month was erased and it was the most desperate and depressing and painful phase i had. For the last 6 month i completely avoid sitting and uncontrolled load at hamstring and tendon.
We must never make the mistake again coming back to early. Like a pro all load tests must be painfree before we go back since sprinting and basketball has very high tendon load. It is sad and i am not sure if i will ever come back or be that explosive.
I tried a lot of exercises and watched hundres of hours physio videos but the only thing that helped me slow but steady were a lot of massages at the beginning and now isometrics i now do for some weeks like Purdam said:
- th-cam.com/video/hjTk_bfNrUY/w-d-xo.html&t=1280
- physio-pedia.com/Proximal_Hamstring_Tendinopathy
- th-cam.com/video/NN5VHGz6DvE/w-d-xo.html
i'm also a sprinter. I know some very good uncommon exercises for the hamstrings. I'm not talkin about RDLs or nordics.
The reason for such overload inyuries are almost always compensation patterns. Basically one muscle region does not do it's job so the other must do it and gets inyured.
Great presentation. I would say though that if you just partially tore a tendon, there's no guarantee that you'll be able to do heavy loads or long holds or both even though isometrics seem to be magical. For example, you might only be able to do 2 sets of 10 second holds with 2 lbs after 1 week of rest after injuring your elbow (let's say, golfer elbow). Also, isometrics can cause pain during and after doing them (can be a sign that you did too much if too painful or a sign that it was fine if the pain is not much worse). So, be careful. Less is more. So if you're not sure, do less and less often at first.
Tendinopathy and tendon rupture are not the same, though. That's a different discussion.
agreed! @@justjustjoo
Do the same principles apply to upper limb tendons, such as distal biceps tendons? I would assume so, but you know what they say about assumptions...
I wonder this as well....elbow problems here.
Excellent!
The presentation speaks about the tendinooathy in legs but I assume it works for the upper limbs as well? I wonder if you need then the same holding time and load?
I have patela problem for 3 yrs ,one year was ok by the time when I used for 20 min jet stream in jacuzzi ,I can't walk for 3 months ,nothing happened pain scale is very low
What to do if you have quad tendenosis
Hello. I have two-sided tendinitis and peritendinitis Trochanterica. Have I understood that correctly now that isometric exercises do not reduce the pain from the inflammation, but I can continue to do the isometric exercises because they are best used to heal for trendinides? Greetings from Germany, Thomas.
I was told that the tendon that didn't get enough rest will have nerves an blood vessels grow into the tendon because it's frayed and that isometric exercise will make the muscle dense and desensitize the nerves and blood vessels that grew into it.
Good!
I have gluteal tendinopathy and bilateral greater tronchenteric bursitis for past 1.5 yrs,started isometric excercise from 5 months,still in pain,how long will it take to strengthen the tendon and be pain free
Where's Jill's presentation on restoring energy? Thank you... Is it Jill Blakeway?
Are there any seminars on mri accuracy for tendinopathies?
I'd love to know this....they seem to say imaging isn't a helpful measure. I'd like to know what the hidden variables are.
How is it not immediately obvious to use unmovable loads as opposed to heavily weighted loads?
For example, instead of holding a heavy deadlift in an isometric hold, you could use an unloaded barbell and pull against the safety bars, preventing the bar from moving no matter how hard you pulled.
The lag of sports research is glaringly apparent due to the researchers having close to no experience in the gym.
Id trust a gym bro than a twig in glasses behind a microscope because the gym bro has tried things to compare. The twig conpares things on paper, but nobody can argue that the majority of things in life turn out to be different than they should have on paper.
I guess the disadvantage of your suggestion as oppose to weighted is that its much harder to measure the intensity so you can't build a progression as meticulously. If you're weighting you can gradually progress increasing the weight each time incrementally but if your pulling its very hard to measure the level of that so each time could be different and its hard to build it up safely.
Keith Baar talks about "overcoming isometrics" for tendons as you described.
Now I have to figure out what Tendon Compression is, because my exercises have only made my PTTD worse.
1 week later
Immediate strength and pain relief from doing isometric double leg calf raise holds. This is something my 2 PT have not shown me and something I've been struggling with for the last 10months.
Daniel_A-24 thanks for the update! 🙂
@@Nick-kf3io No problem man.
Heavy and Slow is next. Isometric don't help forever. I should've moved on to heavy isotonics 1 month after isometrics or even sooner.
I'm now doing plyometrics.
Hi! In regards to warming up the tendons based on research. How do you do it? Thank You!
Any one could give me French traduction ??
How do we actually know is a peritendonitis?
What leg extension exercise did you refer to? Does it involve a machine?
She says "Leg extension on the machine"
Also "Spanish squat" th-cam.com/users/results?search_query=%22spanish+squat%22
After how long can you do 1) half squat with bouncing 2) half squat and rising ( flexed metatarsals) as at the ballet barre with patellar tendon problem?( adult in their fourties?)
Weighty workout
16:05 the runner graphic should NOT be heel striking.
I would remove your over simplified thought on a graphic. Most marathon runners heel strike. Yes, there are different loads on the foot/ankle/LE during heel striking as compared to the midfoot or forefoot.
@@rscranman2002 This is WRONG. They DO NOT heel strike. It just looks like they are heel striking but in fact the last second thy are landing on ball of the feet. and there is NO such thing as midfoot strike. You are either striking on ball or striking on heel.
@@mrzack888 lol…sure thing doc.
She’s cute :)
To much bla bla... big complicated words.. 🙄😒😏. 😴
This seminar is for professionals..