Tendinopathy Exercise Prescription

VSS Team

2 hours ago

2 min read

Phase 1: Initial Tendon Loading

At Valley Spine & Sport, we begin tendon rehabilitation with controlled, pain-tolerable loading. Your clinician will demonstrate exercises specific to your condition.

1. Daily Tendon Loading

Repetitions: 3–5
Frequency: 3–5 times per day
Hold duration: 30–60 seconds
Pain: Mild discomfort (approximately 1/10) is acceptable.
Pain should remain stable or improve during exercise, not progressively worsen.

2. Collagen Supplementation (Optional)

10–15 grams of collagen or gelatin with vitamin C.
Take approximately 20–60 minutes before tendon loading.
May support collagen synthesis.

3. Before & After Physical Activity

For runners and active individuals:

Before exercise: 5 minutes of controlled tendon loading.
After exercise: 5 minutes of controlled tendon loading.
Stay within your pain tolerance.

4. Monitor Your Symptoms

Mild discomfort is acceptable.
Symptoms should not progressively worsen during exercise.
Pain and stiffness should return to baseline by the following day.
If symptoms worsen, reduce loading and contact your clinician.

What’s Next?

This is the starting point of your rehabilitation. As symptoms improve, we will progress your exercises to include heavier strengthening, dynamic loading, and eventually sport-specific activities.

The goal is not to avoid loading the tendon, but to load it appropriately and progressively.

Research & Clinical Influences

Jill Cook, PhD — Internationally recognized tendon researcher whose work emphasizes appropriate tendon loading, symptom management, and progressive rehabilitation. Her research has helped shape our approach to initial isometric loading and subsequent strengthening.

Keith Baar, PhD — Researcher specializing in tendon adaptation, connective tissue biology, and nutrition. His work has explored the potential benefits of collagen or gelatin supplementation with vitamin C before exercise to support collagen synthesis.

Our protocol incorporates principles from their research, adapted to each patient’s symptoms, activity level, and stage of rehabilitation.