About a month ago I started a fairly high volume overhead press training and after two weeks developed some (semi)serious elbow pain. Now, normally I’d believe the reason was sudden volume/intensity increase beyond that what the structures are adjusted to and the solution would be to lower the volume so that the pain goes away and then slowly increase the workload etc.
But stubborn as I am I didn’t want to do that and instead tried doing some isometric barbell curl holds (90° elbow) 5 sets, twice a week for say 20s, RPE cca 8. The pain went away literally the next day after doing these for the first time.
That would indicate that the diagnosis of ‘‘structures being unadjusted to the sudden load/volume increase’’ would be actually wrong as what helped was doing more. Or maybe is there a way to reconsile the two? Also, when someone develops eg back pain on DL, default advice is lower the load so that you feel no pain and work from there… What if there is a solution similar to this one? I don’t know, maybe isometric good mornings or something similar?
Sounds like your experience validated the 2017 isometric tendinopathy research from the La Trobe University in Australia.
They found what works for pain reduction is loading the tendon isometrically, 5 reps x 45 second hold, and progressing up the weight. This is working for me right now as well with my tennis elbow. Their research showed that eccentric work didn’t not work as it’s too provocative to the unhealthy part of the tendon. The second stage is loading the tendon with heavy isotonic exercise, 3 sets x 15 reps, with linear progression.
Thanks man, appreciate the answer.
Though I was mainly interested as to why the usual answer would be the fact structures aren’t used to the quick ramp up of volume and intensity but the solution would be doing even more, so the program + isometrics.
@IndividualThoughPatterns thanks for the questions. Glad to hear you were able to resolve your experience with such an approach. Although this may have worked for you, this would be difficult for us to say what happened or why without studying the situation and having controls in place to minimize biases/fallacious reasoning as well as natural history / regression to the mean / other confounders. Sometimes we just get aches and pains during life that would have resolved regardless of what we do but then layer in doing something and our personal belief in doing that something, and we can “get results” and left thinking it’s because of that something.
I’m not certain our primary message (certainly not diagnosis) is “structures being unadjusted to the sudden load/volume increases”. We usually say someone hasn’t prepared themselves to do what they are attempting but this isn’t meant to be a blanket statement for all contexts either. However, this may include acutely overloading an area (example hamstring strain during sprinting without being prepared to sprint, a common mechanism of muscle strain is eccentric overload). Tendinopathic issues on the opposite end of the spectrum are often thought to be related to persistent overloading to an area over time (not acute).
We also do not say to lighten the load to feel no pain when experiencing acute onset low back pain. Typically we say find tolerable loads for you given your symptom experience (this includes some acceptance of symptoms). Happy to discuss further.
@Kratos - we did a write-up for our monthly review specific to tendinopathies as well as a podcast. We do not think isometrics are a must for tenidnopathic issues, although for some that may be an acceptable intervention.
@Michael_Ray Thank you for explanation. I appreciate it. I would really like to discuss it further as you say, but I don’t feel I am educated enough and would only annoy you.
I’d have to do my homework first and actually increase knowledge base first heh