How to Progress Past Painful Tendon Issues

Last week, we covered the continuum of tendon breakdown and outlined how tendons can thrive or fail based on the stress we place on them. 

You can catch up on that here. 

Hopefully, you found it helpful, especially if you struggle with tendon pain. 

But if you just want some solutions, we'll cover them here.  

Many factors will dictate where you fall on this spectrum of strategies, and training will often blend multiple phases.

It sucks to live in pain. So, the primary goal of getting rid of it is a bit obvious, but the critical point here is that eliminating pain is only a means to an end and not the actual finish line.

With less pain, you free up the ability to load your tendons where the magic happens. 

Therefore, the initial step to addressing tendinopathy is to reduce sensitivity without completely resting the tendon (because rest alone doesn't restore tendon health).

For reactive tendons, isometric exercises (e.g., wall sits, plank holds, calf raise hold) are the most popular tools to work the tendon with some gentle load.

For The Crossover Symmetry 30-Day Shoulder Fix, we recommend 1-2 weeks of avoiding shoulder movements in the gym while doing the CS Activation program as frequently as possible daily.

This phase accomplishes several things, but most importantly, this shoulder deload with controlled movements is like hitting the reset button on pain.

It's easy to get excited once the pain is manageable, but it's critical to gently reintroduce stress to the tendon to kickstart the rebuilding process.

Beginning with controlled, progressive loading to improve tendon capacity without exceeding its tolerance keeps you moving forward without setbacks.

In this phase, machines, dumbbells, and resistance bands are easy ways to control the load and range of motion to dial the appropriate dose.

Again, the 30-Day Shoulder Fix will accomplish this with the prescribed modifications for the Activation series to start with more controlled and less provocative movements.

Once you can take on some loading, it's time to build into more functional movements that align with real-world and sports demands. Increasing the load and intensity stimulates greater collagen production, improves tendon stiffness, improves the tendon structure, and strengthens surrounding muscles.

Heavy, slow resistance (HSR) training and eccentrics are now incorporated to push the load up a notch. For the 30-Day Shoulder Fix, the eccentrics introduced in the CS Recovery Plan help meet this demand for the shoulder.

Of note here, is that we often fear pain during a rehab journey, but a bit of discomfort during exercise is acceptable during this phase. It should remain below a 3/10 and resolve within 24 hours.

As you transition out of this phase, the tendon is strong enough to handle daily activities and sport-specific demands.

Again, you need much more than strong tendons. 

They're also designed to store and release energy efficiently. This stage focuses on improving the tendon's elastic properties.

Therefore, rehab's final stages should use faster movements to train the tendon's ability to handle higher-speed forces. 

This can include speed-focused drills, such as fast step-ups or resisted sled pushes, emphasizing control and gradual progression. The 30-Day Shoulder Fix now introduces the CS Strength Program for a more dynamic and higher load stimulus.

The final stage is about maximizing the tendon's ability to store and release energy, enabling explosive performance.

Now, focus on high-impact, dynamic movements to fully restore tendon elasticity and prepare for intense activity. This includes things like box jumps, bounds and hops, medicine ball slams, and reactive drills. The Activation+ program gets added to the 30-Day Shoulder Fix for the shoulder to work on moving with speed and timing.

Ensure the tendon is pain-free during and after exercises before moving to this stage. Start with lower-intensity plyometrics and progress to more demanding movements over time.

Addressing tendinopathy takes time, patience, and consistency. 

But with a clear progression and the right starting point, you can restore tendon health and get back to doing what you love—stronger and more resilient than before.

I have one more important message I'll tackle next week regarding maintaining our tendons as we age.  With a bit of tendon maintenance, I'm convinced you can fight the natural slow-down that happens as we get older.