Load and tendinopathies: questions and comments on training vlog #31

Hello,

Thank you guys for your content. I’ve really enjoyed watching and implementing it.

I recently watched your guys training vlog #31 (https://www.youtube.com/watch?v=KhJN…amp;amp;t=608s). Specifically, in the first 10 minutes of the video you guys discuss knee pain and load management, with the overarching idea that many tendinopathies could be load management issues.

I think there is some ambiguity in the video because load is never really defined–are you talking about internal load (i.e. RPE), external load (weight on the bar), or some combination of both? Or are you talking about load in the context of just an acute:chronic workload ratio?

The reason I ask for this clarification is to understand how tendinopathies are caused so the programming can be adjusted accordingly. In the knee rehab template, during phase 1 and phase 2 (the bulk of the program is in these phases) it is prescribed to reach a top set with an RPE 10. If tendinopathies are the result of too high an internal load, then prescribing hitting an RPE 10 doesn’t make much sense to me (even though the external load has been dropped below the athletes training capacity in this template).

In all fairness, you guys do include measuring sRPE and acute:chronic workload ratios in the template which, to my understanding, are good measures of internal load. I guess it’s just the idea of hitting RPE 9 and 10 for each exercise that concerns me. (Maybe I’m just noceboing myself here haha. I have some history of knee tendinopathy so I’m afraid that hitting RPE 9’s and 10’s, even on a substantially reduced external load, will yield more tendinopathy).

Please let me know your thoughts. Thanks!

Physiatry,

I think there is some ambiguity in the video because load is never really defined–are you talking about internal load (i.e. RPE), external load (weight on the bar), or some combination of both? Or are you talking about load in the context of just an acute:chronic workload ratio?

We are talking about workload in this case, which reflects the internal load over time.

If tendinopathies are the result of too high an internal load, then prescribing hitting an RPE 10 doesn’t make much sense to me (even though the external load has been dropped below the athletes training capacity in this template).

Acute or Chronic Workload is not the RPE of a single exercise, most of which are isometric in these phases.

In all fairness, you guys do include measuring sRPE and acute:chronic workload ratios in the template which, to my understanding, are good measures of internal load. I guess it’s just the idea of hitting RPE 9 and 10 for each exercise that concerns me. (Maybe I’m just noceboing myself here haha. I have some history of knee tendinopathy so I’m afraid that hitting RPE 9’s and 10’s, even on a substantially reduced external load, will yield more tendinopathy).

It is highly likely that with the given prescription your workload will decline in the first two phases and gradually increase in the third phase.