The Ultimate Guide to Tendon Repair: How Isometric Exercises, Optimised Timing, and the Anti-RICE Protocol Can Help You Heal Faster

Commonly, tendon injuries tend to be insidious and often unnoticed until we put our body through its paces. For example, Tennis Elbow feels fine most of the time until we grab the racket and start hitting, it may feel better after warming up, with the odd pang on certain shots and eventually feel stiff and painful when waking the next day. An Achilles or knee tendon, such as the Patella or Quads tendon may follow the same pattern but with different aggravating factors, possibly jumping or decelerating from a forward or backwards motion.

Although aggravated tendons feel good with a warm up the injury is worsening and could be heading for complete failure (rupture). As tendon symptoms can be masked with a warm-up, RICE and avoiding what aggravates the area in the first place, patients almost always present themselves to a clinic when the injury has become chronic (3 months+), however tendons are quite easy to treat and rehabilitate. It's never to late to seek treatment and rehab but the earlier the better.

Tendons don't just heal themselves like a scab on the skin. If you rest the area and avoid all aggravating activities the tendon still will not heal properly as tendons need to be loaded for healing to occur. 'Good loading' versus aggravating loading. Lets delve into the latest research.

When it comes to managing tendon injuries, the standard advice often revolves around rest and ice. However, the latest research conducted by expert Dr. Keith Baar, a renowned professor at UC Davis/expert in muscle and tendon biology/specialising in the science of tendon health and repair, is challenging some of these old-school methods and offering new, evidence-backed strategies to speed up recovery. If you're struggling with tendon injury, understanding and applying these techniques can dramatically enhance your healing process.

1. Isometric Exercises for Tendon Repair: Uncomplicated and Effective

If you've been told to rest a tendon injury, you might be surprised to learn that doing nothing isn’t always the best option. In fact, one of the most effective methods for repairing tendon injuries involves isometric exercises—a type of exercise where you contract a muscle without actually moving the joint. Dr. Keith Baar, a leading expert in tendon health, swears by these exercises for speeding up tendon recovery.

What makes isometric exercises so powerful?

- Load distribution: Tendons are designed to withstand load, and isometric exercises help evenly distribute that load, preventing stress from being concentrated in specific areas. This can prevent further damage while promoting healing. To put this into perspective with the earlier mention of how the tendon may feel better after warming up, this is because the tendon is NOT distributing the load evenly and the uninjured sections are taking the strain, which is why full ruptures are more likely to occur after a warm-up.

- Preventing stress shielding: When a tendon doesn’t bear weight, it can weaken over time. By using isometric exercises, you encourage the tendon to adapt and strengthen, rather than degrade.

How can you incorporate this into your recovery?

For best results, start with light isometric exercises and gradually increase the intensity. Doing this consistently (just 10 minutes a day max.) helps your tendon gradually adapt and heal without causing further strain. At the Newquay Injury Hub, I can provide a personalised rehab plan that incorporates these techniques, adjusting the intensity and frequency to match your individual needs and injury status.

2. Optimising Exercise Timing and Progression: How to Speed Up Healing

When it comes to tendon repair, timing is everything. Dr. Baar recommends a strategic approach to exercising that ensures optimal recovery without risking further injury. Here’s how you can apply this to your own recovery plan:

- Gradual Progression: Start with a low intensity during isometric exercises and gradually ramp it up. Dr. Baar suggests a 3-second progressive load to the muscle to ensure that you don’t overload the tendon too quickly. This slow progression allows the tendon to adapt without being overburdened. The pain you may feel in a tendon during activity is this overloading which causes more damage and inflammation.

- Rest Periods: Tendons need time to recover, so giving yourself at least 6-8 hours between sessions is essential. Overtraining a tendon can delay healing and cause setbacks, which is why optimal rest periods are crucial. Less Really is more when it comes to tendon healing.

3. The Anti-RICE Protocol: Why Resting and Icing Might Not Be Enough

For decades, the go-to method for treating injuries involved the RICE protocol—Rest, Ice, Compression, and Elevation. However, Dr. Baar challenges this approach with his Anti-RICE protocol, which suggests that controlled movement and loading are actually more beneficial for tendon repair than complete rest.

Why is the Anti-RICE Protocol so effective?

- Active healing: When you rest an injured tendon completely, you're not providing the necessary stimulus for healing. Instead of immobilising the area, controlled movement and light loading actually encourage tissue repair by stimulating cells and collagen production.

- Promoting circulation: Light exercise can improve blood flow to the injured area, accelerating the healing process and preventing stiffness or further muscle atrophy.

How can this approach work for you?

Rather than freezing your injury with ice and resting, the Anti-RICE protocol advocates for gradual reintroduction of movement and controlled stress. This approach helps the tendon repair faster, as the tissue is actively involved in the healing process.

How the Newquay Injury Hub Can Help

While these strategies are grounded in cutting-edge research, navigating them alone can be daunting. That’s where the Newquay Injury Hub comes in, giving you direct access to personalised care that is tailored to your specific injury and goals. Whether you need isometric exercises incorporated into your rehab plan or guidance on when and how to load your tendon safely, we’re here to support you every step of the way.

Get diagnosed quickly and accurately with a hands-on assessment, expert treatment plans, and the latest in rehab techniques to ensure you recover faster and smarter. By combining the insights from experts like Dr. Baar with a foundation of unrefuted data based treatment techniques and a tailored approach, you’ll have the best tools available to manage and repair your tendon injuries.

Final Thoughts

Tendon injuries can be frustrating, but with the right approach, you can heal faster and stronger. By incorporating isometric exercises, optimising exercise timing and progression, and challenging traditional methods like RICE, you can take control of your recovery. I can help you navigate these strategies with personalised care and expert advice, ensuring that you return to your active lifestyle as quickly and safely as possible. Reach out today and start your journey to recovery!