This research recently reviewed over at one of my favorite research blogs, Body in Mind is very interesting.
It basically states that individuals with "tendon" pain had immediate relief following a few short bouts of isometrics. Eccentric loading has traditionally been on everyone's go to treatments for tendonosis ever since crazy Alfredson tried to sever his own Achilles Tendon. Despite being effective in the short and long term, according to research, it can be uncomfortable and even painful.
The new research states immediate and significant relief following isometrics. I use isometrics all the time since I incorporate PNF into my repeated loading and motor control stategies. A well cued isometric contraction at an AROM sticking point or a painful block during AROM/PROM can often quickly and rapidly reduce perceived threat and stretch perception.
In lieu of this new research, instead of using isometrics for "tendon pain" or I guess what I often refer to as issues in the tissues, why not try resistance into or away from the painful barrier to enhance whatever other manual therapy or exercise you are doing? I would progress like this
- light resistance at first "Meet my resistance"
- if decreased pain/discomfort, but not completely, increase or decrease resistance, or change direction
- you should be able to find an amount of resistance and direction that makes it almost 100% pain free
- progress until you reach end range
- overpressure the end range
- repeat until full pain free range is attained
- add manual therapy techniques if not able to make the movement/exercise completely pain free
Keeping it Eclectic....
Want to see how I use isometrics/PNF in The Eclectic Approach? Check out live cases and techniques on The OMPT Channel!