Why Do Muscle Imbalances Manifest as Tendon Pain?

1. Load Tolerance: Muscle and tendon loading follows a specific framework. The amount of load you put on the muscle is limited by the amount of force that it can tolerate generating before failure. The muscle is meant to take all the stress. If your muscle is fairly weak and can’t quite perform the task you are trying to get it to do, you may end up overloading it, which will cause the stress to move to the tendon. This creates tendinitis type pain which is what most soft tissue injuries are.

2. Acute Stress: Your couch to 5k takes some time and progressing too quickly can cause a lot of stress on the body if it isn't done correctly. Acute stress like a sudden sharp increase in load can cause breakdown of tissue because the musculoskeletal system was not prepared. A common one we think about is shins splints (posterior tibialis tendonitis) and happens when we ramp too quickly. Short bouts of acute stress like hard track workouts are good, and can be implemented in your training plan, but we need to be mindful of how much and how often we do them.

3. Overuse: Listen to Garmin and take your rest day. Adding mileage or load on a tired body is an easy way to cause an injury. Chronic overuse breaks down tendons on a cellular level and creates a tendonopathy. Our muscles and tendons need recovery to allow healing to occur, and from that recovery we have growth and improvement. Additional factors in this are nutrition and good quality sleep to ensure we can handle the load we put on our bodies. Don't be afraid to take an off day or even try some cross training to reduce the overall load.

4. Complex Muscle Imbalance: Our bodies are meant to perform dynamic motions. From running to swimming to throwing a ball we put a lot of motions in action in a complex way. Weakness in a muscle group will tend to cause increased demand somewhere else to help complete the action. Strong quads and weak hamstrings can cause knee pain, and imbalance in rotator cuff muscle strength can cause elbow pain baseball players. Not correcting these imbalances increases tendon load and can cause damage over time.

5. Length Tension Relationship: The length tension relationship is simply the comparison of the length of the muscle and tension it has and how that impacts the function. If the muscle is tight you will have a lot more tension through it as well as the tendon, and therefore the load will be unnecessarily higher. If the tension is higher than optimal, it can cause more compression in the joint as well and create more mechanical stresses. This is why mobility is a prerequisite to moving well.

If you're having tendon pain or feel like some of these things apply to you but are not sure how to solve it, we would be glad to help!

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Dr. Dylan Glass, PT, DPT, SMTC

Return 2 Sport PT

www.Return2SportPT.com

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