Here’s another view of my new Tendinopathy Rehab Framework 👍🆕
As I mentioned in this
post when I introduced the framework, it is something I have been working
on for a couple of years.
I’m excited to be rolling it out for the first time on my
course in Melbourne 3rd/4th May 2025. Just few spots left
now. In this course I go through detailed application of the framework in the
lower limb tendinopathy.
I tend to think in terms of level 1, 2 and 3, but as
mentioned in the prior post, the levels are not hard and fast. They bleed into
each other. Here I wanted to explain that a little more.
Within level 1 I’ll introduce some ISOT work with concentric
intent with moderate loads. This prepares the individual or athlete for heavier
concentric intent work in level 2.
Then in level 2, I introduce PLYO prep work which is largely
about landing and decelerating effectively and fast, powerful single (as
opposed to repeated) jumps. You may be asking, isn’t a repeated jump just a
hop? Well, it depends. In hopping, we minimise ground contact time to maximise
tendon elastic energy return from the muscle–tendon unit. Jumps are biased more
toward slower ground contacts and greater muscle bias. (PS: side note—I hate
when people call a double-leg hop (based on the definition above) a jump. It’s
not a jump! Sorry… grumpy old man moment.)
Level 2 also involves some lower intensity and volume “training’
prep. My definition of ‘training’ is anything that is super specific to the individual’s
activities or sport. Stuff they would be usually do. This could be walking,
running, sport.
These prep phases are important for setting up the
PLYO work (both repeated jumps and hops), skill based PLYOS and
progressive intensity ‘training’ in level 3.
NOTE: in terms of the tempos, these are indicative. You can
play around with these depending on the individual and what you are trying to
achieve and focus on. For example, if patterning is the goal, slow, paced
(metronome) work is beneficial. If capacity is the focus, speed up the
concentric tempo a tad and maximise it for power/RFD.
The key takeaway: For me, this framework replaces the current way of rehabbing tendons — where it's advocated to progress from ISOM to
ISOT and then PLYO. Of course, some people do start with
ISOM because everything else is too painful. But if you stop at that rationale for choosing a load type, you miss
out on the incredible benefits that come from thinking more deeply about
tendon rehab prescription.
Last word: It might seem complex, but it’s actually simple. You don’t
do all of it for everyone, and it certainly isn’t a linear progression. You
tailor it to the individual in front of you — their needs, goals, and
preferences.
