Tendon Talk - The different phases of tendinitis (tendonitis) using a model.

In this video, Anthony uses a model to explain tendinopathy and tendon rehab.
If you like this video, please consider liking and subscribing to our channel.
You’ll see Anthony explain tendon pain and inflammation, and discover how, as a physio, tendon treatment is organised.
Work through the stages of tendon damage, from normal response to load, tendon swelling and tendon inflammation, through tendonitis and tendinopathy.
What is Tendinitis (tendonitis/ tendinopathy)
Hi Guys, It’s Anthony from Grandstand and today we are talking about tendons. We’ll discuss how tendons respond to load, what happens when a tendon is overloaded and most importantly how to manage a tendon when it starts to break down.
We are going to use a rope model to help describe what is happening in your tendon. We’ll see how load affects a tendon, including how the tendon responds to keep it healthy. When the load is too great. or the rest period between exercise is too short, the we start to see the cumulative damage within the tendon structure. this is what we term tendinitis or tendinopathy.
There are different stages in tendinopathy or tendinitis, from swelling and stiffness, neo-vascularization (infiltration of nerves and blood vessels in the tendon matrix) and tendon tears.
Having understood the various stages, we then look at how to rehab the injured tendon. You will see that for most stages, applying load is going to be the best solution for returning the tendon to full health. The amount and type of load will differ, depending on the stage of tendinpathy, or tendinitis, however, it is rarely a good idea to rest the tendon completely.
You should understand that within any tendon, particularly the overworked one, you might have various stages occurring in different parts of the tendon. It is imperative, therefore, that you match the load applied with the tolerance of the tendon. Seeking advice from a physiotherapist will help you to make informed decisions as to managing your tendon injury, and return you to activity as soon as possible.
Of course, if you would like more information, contact us at [e-mail] or www.grandstand.clinic

[@grandstandclinic]

We'll be covering specific tendinitis injuries, such as achilles tendinitis, in future videos, so stay tuned!

[@joshl1984]

would a burning and tingling sensation be symptoms of the stage where the tendons have nerves and blood vessels that are producing pain?

[@nataliamartigon7744]

I have trigger finger ,and they told me today is my tendons,can you please give us some exercise for my both of my hands.

[@GhostsQueen85]

How can I rest my tendons if the affected areas are my hands and forearms? I have to use my hands every day, whether I'm working, bathing and feeding myself or whatever. So what can I do to help myself heal faster if it's an area I can't actually rest all the time?

[@medusaspupil]

How can you tell when the tendon injury had enough rest and it's ready for exercise?

[@samueldiaz7105]

Thank you useful absolutely

[@theodoreblackwood6524]

I've watched 20 videos like this one trying to understand how to treat my tendonitis and this is the first one that genuinely explained in a clear and concise manner how the tendon works and what you should do to treat it. Thank you.

[@xXAquarangXx]

kneesovertoesguy is great too

[@jonjay9991]

@@xXAquarangXx he a fraud bruh

[@xXAquarangXx]

@@jonjay9991 no he is not, I couldn't walk without severe pain and within less than two years of following his programs I got to a d1 level in track. Pain gone and new strength was found

[@akmedo]

@@jonjay9991 a fraud, something happen?

[@JSustain]

Same here. I finally understand what the heck is going on with my Achilles Tendonitis.

[@cherryl225]

i cant believe how perfect and concise this explanation is. what really intrigued me was that the cause of pain is the veins being squeezed by the tendon fibers, and that the isometric exercises desensitizes them. i learned so much about this in the last couple weeks, but your explanation in particular really tied it all together as the last piece i was missing in understanding this injury. i feel equipped to end this tendon pain and never let it happen again. thank you so much for explaining it like this. in my case, years of knife-like pain stopped within 4 sessions of wall sits and slant board eccentric squats, 3 days apart. i cant believe that i can walk so smoothly after so many years of hobbling and guarding. mine is in both patella tendons.

[@n08011]

How are you feeling now? And do u have any tips?

[@ZanahorioGaymes]

Thank you. This gives ne hope in recovering. I've been trying to get my arms treated but it feels no doctor takes it seriously

[@bellam6511]

Yep same here..😥

[@magicd9]

Exactly. Same here :(

[@jonathanhernandez3628]

Exactly same here smh I feel so helpless 😔 but this video gave me some hope

[@Mario9640]

same

[@dhaval0007]

Thanks for using the model. That cleared tons of questions

[@HoytMcBeth]

The rope prop was fantastic! Anatomy and descriptions thereof always throw me when I am being treated. A great visual and clearly explained. Thanks so much!

[@clientaaarei8367]

GREAT Explanation!!!! You're a True Teacher! Thank You for taking the time to Educate us on this!

[@nimascolari1508]

Brilliant. Great job.

[@englishincontext4025]

Superb video. I've waded through many videos on the subject and most of them are filled with waffle. This presenter doesn't use one superfluous word and the rope analogy is terrific. Very clear. Having done the 'rest; thing (doesn't work) and the Isotonic thing (makes it worse) I'm currently looking at applying moderate load using stretch bands and isometric 'exercise'. So far it hasn't gotten worse and I think it may be beginning to help - though I've had 'golfer's elbow' for quite some time now. I don't expect improvement to be rapid, but that's OK. What's important is finding the right approach. Thanks very much for this terrific video. 👍👍❤️

[@clintonalexander2765]

Best explanation out there so far.

[@ianvanaperen8826]

Most intuitive. Concise explanation with a great rope aid to demonstrate how and what it looks like. Well done and thankyou.

[@robroy8485]

Brilliantly explained- liked the rope analogy 👍🏻

[@em.pxthetic]

This video is actually the greatest of all time.

[@TheOGDesigner]

Great visual explanation, thanks!!

[@robbym8573]

absolutely brilliant explanation.

[@ahmadalghamdi5745]

Amazing explanation, that rope example made it really clear and easy to understand.

[@royspier9393]

very informative. Thank you

[@thebestthingthatneverhappe6729]

Hello, video was very insightful. Understanding that the same tendon could be at any of those 4 stages as various locations of the tendon really helped me understand. Treatment varies with stage. I have rehabbed patellar tendinosis 4 times over the past 10 years to return back to basketball. Each time it took slight variations in the loading protocols. This explains why. Could you provide any further insight on patellar tendinosis like you did with the achilles? It would be greatly appreciated. Thank you

[@jamie5397]

Best simple explanation of Jill Cooks research that I have seen. So much bad tendinopathy videos out there. This should have more views.

[@cac7865]

So clear and easy to understand

[@gustavofring-thechickenman]

Fantastic explanation, thank you 🙏

[@christophvolar3481]

So informative! Thank you!

[@rusev5490]

The best videos that i saw in a while, just run a half marathon with an already swollen tendon and i am resting and started my so called rehab. Going to see a physician as well but that video is really informative and well done, good job.

[@grandstandclinic]

Thanks Rusev, good luck with your rehab!

[@fhjfhdgh]

Best explanation i could find! Thanks alot

[@tomersadot]

Beautifully put! Thanks

[@konosalex9783]

that is beyond informative thank you very much ❤️

[@jamesoconnell30]

Very well described. Thank you so much

[@tshankiti8070]

Clear explanation, excellent. Ty

[@emilymetz6638]

Awesome analogy, thank you

[@FitFeens11]

Thank you so much for making this!

[@kimberlylullo5843]

Wow! Great explanation! Thank you!

[@healanimatthews1140]

This was an amazingly informative video.

[@pepekont3736]

Thanks for the great explanation

[@St-Abbed]

Thank you, sir! Very insighful and perfect illustration. I now feel like I know everything I need to know about tendons. (Sub well-deserved🙏)

[@mikaelohlson5120]

Best explanation ever, good job😊.

[@wojtekmeritum1206]

You have covered the topic so well!!! :)

[@Bisse_Elison]

This is such a great video.

[@SethuNagappan]

Best explanation.

[@BosisofSweden]

This was the best ever!!!

[@mtr3754]

Fantastic video!

[@badmintonplus9278]

Man he explained that in such simple terms

[@qwertyuiopasdfghjlkl6398]

Fantastic video

[@gabingofernandez6431]

Incredible video on the topic :)

[@theintuitivespace8544]

Very interesting and helpful thank you

[@curtzimmerman]

Nice helpful video. I have chronic Achilles tendonopathy. I have been dying to find some relief. After alot of research, I am wearing one inch heel inserts and doing isometric loading which is loading for 45 seconds 4 times with 2 minutes rest in between. I am starting to see improvement. That seems consistent with this video, so I highly recommend this video

[@grandstandclinic]

Hi Curt, sounds like you are on track, LOADING is key. Look to progress to isotonic and eccentric exercises as the tendon improves. Good Luck with your rehab!

[@chrisbeveridge3066]

Thanks grandstand!!!

[@willmcallister8464]

Brilliant vid

[@arunmoses2197]

Helpful video sir.

[@emirashier]

OMG is fantastic. How could one choose the right load for the tendon? how much rest is enough. I typically rest at night and during work before my ballet training in the evening.

[@4PMAnak]

Great Video, really informative.

[@grandstandclinic]

Thanks Ryan, glad you enjoyed it!!

[@seanhurley4003]

Very helpful!

[@SSArcher11]

excellent presentation

[@grandstandclinic]

Thanks SSArcher11!

[@lewisjones1123]

I’ve had this almost a year and am very worried and concerned am off work as my job is driving and it hurts on the clutch and I love the gym. My life is actually on the line with this condition. Am 6 weeks into recovery

[@Dez_27]

good luck man, im praying for you. its important to keep getting the right nutrients and staying hyrdrated!

[@justwatchingffs371]

Fwiw in my case all sorts of different tendon pains went away at the same time after taking ashwagandha and upping my consumption of fish oil for a few weeks. I stopped taking the ashwagandha due to nausea, but keep popping those fish pills like a druggy, and so far so good. Night and day. Also, look into the keto diet and its effect on inflammation.

[@dreamcast3w525]

Muito bom, muito obrigado pelas informações.

[@dylancooper4502]

Good information, this makes more sense about rehabbing my achilles.

[@grandstandclinic]

Thanks Dylan, tendon injuries can be difficult to manage, but understanding what is happening in your tendon can make your path to recovery much clearer!

[@debdrum]

This is an excellent video!! The best explanation visually of what's going on with a tendon!! Thank you!

[@muntefly8163]

Nice and cleare explanation ! About tendon inflamation, what you recommand ?

[@azsegrxdhtfgvijnkomlewrhtg9508]

I had patellar tendonitis from September to March which at that point wasn't getting any better but I could still run on it the whole time. Somehow running doesn't have any effect on my patellar tendons. But then I developed tendonitis in the front of my ankle and top of my foot back in February which made me think I wasn't going to be able to run at all the whole summer and maybe beyond because just trying to strengthen the tendon wasn't doing it for me. I just kept ending up aggravating the tendon and disrupting the strengthening routine and getting nowhere with it. But then somehow I found out that I can really aggravate the tendon often and still heal and get stronger if I'm also trying to rest it as much as I can and applying lots of cold and hot to the area of the tendon. The cold and hot is very important. It has helped me heal tendonitis almost like it's nothing. I also had Achilles tendonitis recently too and it wasn't necessarily easy but I healed it without even having to disrupt my workout routine and I workout hard but I had it healed in a couple of weeks.

[@ShervinShares]

How do we find the right load & exercise for our injury or tendon?

[@piyushanand6939]

Thank youu!!!

[@giuseppetrovato1992]

Hi, great explanation! I've watched hudreds of videos about tendons injury trying to understand how to heal mine, which at the end has been considered as insertional tendonitis on the tibial tubercle. Does all that you explained apply to me? It's been several months now and the pain won't subside.

[@109bati109]

thanks

[@hmdfit]

Perfect explanation! Im gonna buy me a rope.

[@akshaykumarak.6299]

Thank u 🙏

[@alexandram1639]

Thank you. What do you thank about the choc wave therapy ? Is it usefull ?

[@angelg3986]

I am watching this after I pushed my fingers too much trying to learn guitar. I got to the trigger finger symptom in 2 weeks. Now I am trying to assess the type of damage and the proper way to deal w it. Stopped moving the affected finger, but started to go swimming. It seems to not make it worse.

[@joshl1984]

Can u tell me what kinds of exercises to do for the degenerative stage ? You said isometrics and loading not sure what those are.

[@chrisbeveridge3066]

Grandstand one final question and I won't bug you again what's your take on EPAT? Thanks so much I value your input!!

[@grandstandclinic]

I've seen some good results with shockwave (and some times where it makes no difference), but I really can't explain how it works. Try it and see what you think. If it allows you to load more, than it's a good thing!

[@cfreeze3691]

Any tips or exercises that can be done for a longitudinal split tear of the Peroneal brevis tendon?

[@gregap8282]

I have so much anger, I can't even deal with it. My tendon doesn't recover, I've been going to physical therapy for the last 6 months, 2 times per week and I don't know for what. I'm so frustrated with it.

[@AmericanPatriot-st1mi]

I read that Magnesium Deficiency will cause the tendon not to heal. That being said 600 mg daily is the suggested dose. If you’re not seeing a real improvement then you can increase to 900 mg a day. From what I’ve researched the muscles give us the increased strength for what need, and Magnesium will then cause the muscles to relax, rather than tighten. So, magnesium deficiency is the root of the problem. I hope this helps. 🕊🤍🕊

[@gmy33]

This is so fckng clear !!! Incredible !!!!! Thankyou thankyou !

[@melissabateman7805]

thank God for this simple, straight forward explanation. Ugh. It's hard to find helpful info!

[@user-tt2hn2no9b]

Dear Antony! Please tell me, whether it is possible to completely cure neovasuliarization?

[@chrisbeveridge3066]

Is friction massage good for restoring tendon...is walking considered "loading"? Thanks a bunch presentation was dope!!!

[@grandstandclinic]

Hi Chris, I don't think there is much value in friction massage, I think it tends to annoy an already irritated tendon. Walking is absolutely loading, particularly if your tendon is pretty unhappy.

[@JohnSmith-cz3us]

chris beveridge massaging fibrotic, damaged tissue is paramount to healing it. If there is scar tissue and adhesions present, these must be broken up and relaxed and re-aligned. I’d recommend performing massage 2x a week evenly spaced out. If you suffer from tendinosis, you must elongate the damaged tissue under progressive load (eccentric exercises). The rate at which you both perform exercises and rate you increase loading can vary but so long as there’s gradual progression AND ADEQUATE rest you will heal the damaged tissue over time. The key is to be patient with your exercises and not to rush it. You must be particular about your diet too, taking in a highly anti-inflammatory diet. High grade fish oil is your friend. Glucosamine sulfate and MSM are also heavy hitters.

[@Casualyoutubee]

so i ran 28 miles and now my tendon is very sore after i walk a short distance, sounds like a should lightly exercise it? Thanks for the help!

[@humble_killer-6938]

I saw a video talking about crossfriction for example on patella pushing left and right on it what do you think about this

[@Fargosportsmassage]

People Like you makes this beautiful world a paradise happy to live in...and TY

[@badoboss294]

Well this video just increased the fuck out of my depression, I got a partial tear in my extensor tendon in my elbow and anthony basically said that this tear wont ever heal up.FML

[@markmiller7834]

Very educational video. I've had tendonosis for years. Tendons are sore and heals are very sore. It's difficult to walk in the morning and especially difficult if during the previous day I've walked a lot, run, skied, etc. I've tried stretching, calf strengthening, deep tissue massage, ART, Graston, etc. Nothing works. Any thoughts? At this point, I'm going to look at surgery.

[@grandstandclinic]

Hi Mark, I guess you need to understand why your tendon is not coping. It's a case of determining where the overload is occurring, whether it be total training volume or a biomechanical issue.You might like to have a look at our achilles video, which explains some of this (kzbin.info/www/bejne/n32oi6qwacqrqsk). Appropriate loading is nearly always the solution, but you need to figure out (through trial and error) what this is! I'd have someone look at other factors up the chain to see if you are missing an additional stress ie increased internal hip rotation or decreased ankle dorsi flexion. Look closely at shoe selection as well. Once you have identified all the stresses, you will need to manipulate these to have a training effect on the tendon, persistence pays dividends. Good luck with your rehab!

[@markmiller7834]

I had gait retraining three years ago. Had been over striding plus low cadence. Helped a little. Had pt to loosen hips. Also, helped a little. Have only run 5 times in past four months but have done elliptical and stair machine lightly. PT said she could feel the nodes//scar tissue all over achillies and calf.

[@grandstandclinic]

Yeah, it sounds like you have tried a lot! I wouldn't worry too much about the nodes/scar tissue. In my experience, I have found that the 'feel' of the tendon doesn't really affect prognosis/recovery. I suggest, go back to basics, commence a loaded strengthening program and understand that pain with exercise is to be expected. It's more about how quickly you recover from exercise bouts. Have a look at Jill Cook or Peter Malliaras' work for more information. Both are world leaders in understanding tendon recovery and you might find some aspect of your rehab that you are missing!

[@grandstandclinic]

Oops forgot to mention... I'm not sure where you are, but we find that an early return to running using an Alter G treadmill is really effective in achilles tendon rehabilitation. Maybe have a look around and see if there is an AlterG in your area. This will allow you to run at a reduced body weight, but with normal joint mechanics. Absolutely worth investigating!

[@haloforgeguy453]

Are throbbing and nerve pain like systems common with neovascularization. Believe I’ve had tendon issues for a while and recently had a severe flair up again

[@adrianosparlapipas]

Hi, i got some peroneal tendonitis at the 5th metatarsal from ankle sprain and then from jumping exercises at basketball , do the same things apply about loading the tendon? also should i stretch while it is still inflamed (a bit)? thank you!

[@dianabouchard6698]

Which nutrients would you recommend to relieve tendonitis?

[@abualzuaree]

I'm 5 months into this insertional Achilles tendinitis issue (superficial tears the Mri said ) I still feel it flare up after some physical therapy (single leg heel raises, balance workouts, etc.) But I have gotten better forsure. I have not done surgery either. When is it OK for me to start doing fast twitch workouts like running jumping etc? Should do it anyway to test myself out? Or would that be risking further injury to the Achilles because it does still flare up on me here and there but nothing too drastic

[@HananGrow]

👏👏👏

[@MobileAura]

I don’t know… As somebody who has actually lived with this for 4+ years, the only thing that actually helped me was completely avoiding any and all exercise until I had zero pain. Exercise is what damages your tendons IMO. Build up EXTREMELY slowly. Even 2 pound weights might be too much for a damaged tendon. IMO rest is king, exercise with pain is risky/can reverse healing.

[@beniaminradomir9798]

Zero pain when resting or zero pain when doing exercises? What if pain never goes to zero?

[@gmy33]

For people with for example structural achilles problems . It is very true it does not get better with rest !! You need to make it carefully stronger !!

[@MobileAura]

@@beniaminradomir9798 Zero resting pain, exercise is completely off-limits/crazy to think about.

[@MobileAura]

@@gmy33 Tendinitis never heals with “therapy” that’s a myth/dangerous lie.

[@MobileAura]

@@beniaminradomir9798 Also, the pain could take 3 years to go to 0, or it could take 40, it’s your choice. I had to COMPLETELY 10000% stop using my thumbs for 2 YEARS to get over it.

[@AustinLNale]

“Avoid rest” seems to be the opposite of what I’ve mostly heard for how to get over tendonitis… do you have any videos ghat explain more on why I should be avoiding rest?

[@AndreiDamian]

kzbin.info/www/bejne/n32oi6qwacqrqsk

[@hogspawn]

What is good nutrition for repair

[@fabienfernandez500]

Wow this video was different from thousands of uploaded videos. I had a degenerative tendon in my left dorsal foot going to 7 months this February 24. Could you suggest a correct treatment 🙏😇

[@grandastra]

Look up Jake Tuura on KZbin. Phenomenal

[@foowishamewican]

What about if I've got multiple issues with multiple tendons....I suffer from hypermobility

[@n2alps]

Is there anyone in Melbourne that you recommend

[@MrSoggyjocks]

I am 44 and a few months ago i decided to get back into shape. Cue ominous thunderclap and lightning. Doing some heavy barbell curls on my first day back (in an obvious cliche of old man doing too much too soon), I damaged some (from what i can tell from self palpitating) tendons in my upper forearm. I assumed tennis elbow, the dr says tendonitis... Its taking a looong time to recover. I am wondering if this is now permanent. I still feel those injuries whenever i use my arms, especially contracting the bicep, and doubly so if that contraction involves forearm rotation. Its really debilitating as to the things i can do with my arms without pain. I can really feel it doing bench, or overhead presses, on the negative portion of the rep. Its been months, and i stopped all exercise entirely to let it heal. I have been doing some stretches i have devised myself, a few that i have seen on youtube, which i can really feel stretching the painful parts of my elbow (where the forearm tendons insert on the upper arm). Thats helped in terms of day to day pain, but i cant train in any respect without inflaming these old tendon injuries. I tried doing some light pressing exercises today, weight i can easily do for 10 reps and more. I still feel the tenderness when lowering the weight. It sucks hairy buttocks.

[@hacksinlife914]

Pls do a presentation oh how totally raptured achilles tendon connect it self naturally

[@percyfaith11]

Doubt that's possible. Surgery is probably needed for optimum result.

[@martineilertzen2226]

HSR training is Also good!

[@myscreen2urs]

Are you saying a tendon tear never mends again? I find that hard to believe. I tore my supraspinatus 10 years ago and that managed to mend, so I was told by radiology after follow up ultrasound🤔

[@zsevenz1100]

I have calcification of my tendons in both shoulders. I been a heavy equipment operator for 25 years. And now im currently unable to work for the past 2 years. Workers comp doctors and adjusters dont believe my tendonitis is caused by work or aggravated by work. Which it clearly was documented through work and by my orthopedic surgeon. Would you guys be willing to give a supporting document or email saying “tendonitis is caused by repetitive motion at work”? Would be helpful to have your support since you guys are experts in the field. 🙏🙏🙏😊🙏🙏🙏

[@staywoke4196]

Are you talking about tendinopathy aka: tendinosis or tendinitis?

[@chadr2604]

Anabolic steroids that run igf up way high also give relief but they have lots of side effects and getting a doctor to prescribe them is next to impossible. The peptides to run igf up high work almost as good with fewer side effects and are technically not illegal.

[@109bati109]

I have a lump in achilles,which part to do than

[@roccoortiz8960]

Idk know which I am or where I am at. I just simply cannot fully extend both my arms with out having pain

[@noexplosionsnolife.296]

I need help my shoulder hurts really bad and this happens to me a lot because I sleep on my shoulder a lot.