so when you try to transmit force through it it gets mad at you and since tendons are avascular once that healing ship has sailed that's it it's over that will be the state of the tendon forever unless you get proactive and do something about it [Music] what's up guys alicon here here today we're going to talk about tendinitis how to fix it how to cure it once and for all and today i'm going to give you guys a plan of attack for how to go about fixing it that i've used multiple times with great success so tendinitis or as it's often referred to these days tendinopathy the former term here implying that there being some degree of inflammation of the tendon right however it's now known that not all painful tendons are actually inflamed so the term tendinopathy here refers to general tendon pathology and in the case of many tendinopathies what you have is not necessarily inflammation but rather degradation of the tendon and the thing about tendons is they are relatively a vascular tissues right they do not have good blood flow compared to muscles for example so if you just leave it alone if you have a painful tendon and you just leave it alone it's never going to actually heal and this is why the old school advice of just resting them and using anti-inflammatories until the pain goes away is flawed advice it's not really going to help you this would be akin to noticing that you have a crack in the foundation of your house and decided to move out of the house for a couple months under the assumption that when you move back into the house a few months later the crack will somehow have disappeared that it'll just be gone but obviously that won't happen and that will never happen the crack will still be there when you come back because you never fixed it and this is the same way that your tendons are if you have a tendinopathy and all you do is rest it then yes the pain will probably go away in time because you've likely ceased performing the aggravating activities the activities that were causing it to be annoyed and hurt in the first place however in that case you have done nothing to fix the actual problem at the root here which is degradation and disorder of the tendon and its cross links thus the minute that you return to normal activity the pain will come right back because the tendon is still broken and it still cannot perform its job correctly which is to transmit force from the muscles and into the skeleton an analogy that i've heard and that i like is to think of the cross links of collagen that make up your tendons as bundles of spaghetti noodles right they're tied up in nice perfect and straight line bundles right and when you injure one of them when you injure a tendon some of those spaghetti noodles they snap they break and in the presence of an acute or a semi-acute injury the body will do its best to throw that back together it'll put your tendon back together it'll stitch it up as best as it can but inevitably with all the scar tissue and the trauma and the panic of there being an injury and the body just reacting to that injury you inevitably end up with some crisscross type so now instead of having perfect intact straight line beautiful bundles and neat rows you end up with a mishmash of of broken pieces all strewn about and sewn back together in a haphazard fashion now the acute phase of any injury eventually passes right the body stops worrying about it and eventually the inflammation goes away so you can potentially end up having a tendon injury that for all intents and purposes has healed even years ago the body considers it done with it doesn't care about anymore because it's done with it at that point but the tendon can still be painful because the spaghetti noodles are all broken up and sewn back together haphazardly the tendon is in a chronic state of disarray and disorder right so when you try to transmit force through it to have it actually do its job it gets pissed off at you and since the tendons are a vascular once that that healing ship has sailed that's it it's over there's no more blood flow and there's not really any more healing that will take place at that point and so that will be the state of the tendon forever unless you get proactive and do something about it and so today i'm going to give you guys a plan of action for dealing with these annoying tendinoses and tendinopathies that are just an inevitable part of training hard of hard weight training right everyone gets them there's no shame in it but dealing with these injuries and moving past them in a swift and efficient manner is something that every hard training lifter and hard training athlete needs to figure out if they want to stay in the game for the long haul and continue performing the activities that they love without requiring significant modifications to activity i have personally used the method that i'm going to outline here today to cure bicipital tendinopathy in my right arm right here at the distal tendon on the biceps right where it meets the elbow i originally got that one from going pretty freaking nuts with weighted chin ups for a pretty long time there i hit a lot of good pr's in the process but i should have stopped that one sooner than i did and i left that tendinopathy alone for a couple years really simply because i was too freaking lazy to deal with it but because of that laziness it went from a minor inconvenience to eventually getting to a point where i couldn't really move my arm without pain and i couldn't even set up for a strict overhead press i could not press overhead anymore because this position puts a lot of stress on the tendon and it was pinching it and it just put so much damp pressure on it that i couldn't do the lift anymore and so when it got to that point i kind of knew that i needed to do something about it and so using the methods that i'm going to describe here today i was able to heal that tendinopathy completely right and it's been a couple years since then that i did that and it still feels 100 these days right up to this very moment now as mentioned a minute ago we know that the job of tendons is to transmit force from the muscles into the skeleton right so accepting and transferring load is something that a tendon absolutely must be able to do without becoming aggravated by doing it and so that means that exposure to load is a necessary component of encouraging proper tendon remodeling as opposed to total rest which is what you used to hear and which is what you'd probably still hear from a traditional general practitioner right now another aspect of tendons is that they are a vascular they have poor blood flow muscles on the other hand have very very good blood flow and so muscles can heal very quickly whereas tendons are notorious for healing very slowly and so another component here of encouraging tendon remodeling will be high frequency bouts of low load activity designed to pump massive amounts of blood into the tendon so that true healing can take place now this isn't an official part of the protocol but it's something i've used on myself with pretty good success and it's a pretty cheap addition and it can't hurt anything so i also recommend using a voodoo floss band every day on the affected area just for a minute or two a voodoo floss band is really just a thin rubber band right and you wrap that band around the affected tendon in order to create a compressive effect and then with that compressive effect you move the tendon and its accompanying joint through a couple different stretches or low intensity exercises and movements now it's not known for certain why voodoo floss bands are helpful with tendinopathies but it's theorized that the compressive movement helps to encourage proper reorganization of the collagen crosslink so basically realigning those broken spindles of spaghetti noodles that i was talking about earlier as well after you remove the band after you remove the compression the rush of blood flow into the area that's released into the area is also thought to be helpful for healing and either way the voodoo floss bin does seem to be beneficial for tendinopathies i did notice some benefit in myself so i recommend starting off your protocol here each day with just one minute maybe two minutes of voodoo floss you don't want to wear it for too much longer than that because you are cutting off the blood flow remember so but wrap the area up moderately tightly and then just move the joint around if it's a knee or a hip you can try doing some lunging movements if it's an elbow then you can curl a very light dumbbell or knock out a few push-ups but basically that kind of thing and now on to the official protocol first up is phase one and here you wanna find an exercise it hits the affected area hits the affected tendon and reproduces your pain to a slight very slight degree so you should start off with a resistance level here that allows you to get in about 20 clean and smooth reps without having your pain exceed a three on a scale of one to ten and that's by the end of the set so you should never have your pain exceed three on a scale of one to ten if it starts off higher than that then you're using too much weight if you end higher than a three after you've done a bunch of reps and accumulated some fatigue then you're using too much weight okay now after you do the exercise the pain that you have gotten in the joint in the tendon that you've created should not linger for more than maybe one or two hours at the very most initially and then over a period of several weeks it should begin to fade away almost entirely and as the pain fades away you should very very gradually increase the resistance that you're using on the same exercise in order to apply more load to the tendon if the general pain level does not decrease at all while you're doing this or it actually gets worse after two weeks of starting this phase then you should choose a different exercise because it means that the one that you're currently using is probably not acting therapeutically for the tendon but once you've found an effective exercise for this that goes through these steps and and behaves the way that i've described you should perform that exercise twice per day every single day once in the morning or the early afternoon and then once again in the evening for example with my biceps tendinopathy i performed regular dumbbell curls just regular old dumbbell curls twice per day every single day for sets of 20 reps i started the protocol out with just 10 pounds per arm just 10 pounds and i had a pretty slight pain slight to moderate pain in the bicep when i first started off with just 10 pounds right now i did it every single day and after about two or three months i had slowly increased the load from 10 pounds all the way up to 25 pounds per arm with no pain whatsoever so i started with 10 pounds and a slight pain a 3 out of 10 pain i ended with 25 pounds and a 0 out of 10 pain and remember this was a tendinopathy that had lingered for two years before i decided to tackle it two years it lingered i couldn't overhead press because it put too much pressure on it from this position so that's pretty crazy two years at lingard and i cured it in about three months when i finally decided to knuckle the down and fix the damn thing so the most important parts here though are to find an exercise that reproduces the pain slightly just slightly and then you use that pain as your guide a little bit of pain initially means that the exercise is stressing the area and if that pain dissipates quickly after you're done then you're taking steps forward right you're you're moving in the right direction but if that pain lingers for a long time after you finish stressing the tendon and working the tendon then you're stepping backwards you're going the wrong way and when you're doing the right thing here when you're actually on the right track the pain will actually begin to fade away very very quickly to a relatively substantial degree over the course of just three or four weeks right i had a very substantial reduction in my initial pain level after just a month of performing this protocol correctly you just have to be sure to perform very controlled reps all the time you shouldn't be pumping out anything explosively the very first step is slow controlled movement you have to be consistent and you have to do the exercise pretty much every single day i was doing it twice a day but i think the more frequently that you can do it the better honestly once you have found the right exercise and from there you have to increase the load very very slowly over time but only if the pain level continues to dissipate if it's not dissipating then you shouldn't be increasing the load remember the main goals here with this phase are to pump a lot of blood in the tendon in order to encourage tendon remodeling and to create a baseline level of load tolerance within the tendon and next up is phase two and phase two consists of controlled eccentric work now phase two i recommend starting about three or four weeks after you've initiated phase one but again you should be using pain as your guide if you've been doing phase one for a few weeks and your pain level has decreased to a moderate degree then it's probably a good time to start phase two at that point but if you've been doing phase one for a few weeks and your pain level has not decreased at all then you shouldn't be starting phase two yet it's too soon you need to build up a baseline level of load tolerance within the affected tendon as well once you do decide to initiate phase two you should continue to perform phase one concurrently the entire time that you are performing phase two now phase two is a little bit more intensive than phase one so you should only perform this portion of the protocol two times per week but for phase two you need to find an exercise that stresses the tendon and you can perform that exercise for three to four sets of six to eight controlled negative only reps so for example if you have a biceps tendinopathy like what i had then eccentric only chin ups with a supinated grip are a perfect option here now if you have a distal hamstring issue a hamstring tendinopathy around the back of the knee then for that you could use a leg curl for a proximal hamstring issue a hamstring problem that's right up around where your butt meets your hamstring then an rdl would be a good choice for that one for an achilles tendinopathy you could use a calf raise for patellar tendinopathy at the knee something like a heel elevated squat would probably work in any case the same rules as phase 1 still apply your pain should not exceed a three on a scale of one to ten while you're performing the exercise and it should not linger for more than one to two hours afterwards otherwise the stress is too high for the current load tolerance level of the tendon and you will begin to regress and remember these have to be controlled negative only repetitions we're not applying explosive force into the tendon we're not applying any ballistic forces into the tendon we're not bouncing off of the tendon it's controlled negative only repetitions that is the most important part about this that you have to get right okay now over time you should slowly add resistance to these negative only reps so long as the pain level continues to dissipate you could add probably five pounds at a time every two to four weeks depending on what area of yours is hurt in my own case i was doing negative only chin-ups i think i started with 25 pounds something like that by the end of my protocol i had worked up to doing negative only reps with something like 70 or 80 pounds and again i did not have any pain when i was performing those repetitions by the time i got to the end of the protocol all told i would say that you should perform phase one in isolation by itself for about a month and then once you initiate phase two you should perform phases one and two concurrently for probably another two months after that bring the total duration of the protocol up to approximately three months now by the time you reach this point you should have a pretty good idea of whether you've been heading in the right direction or not if there's still some small lingering pain then you may want to continue the protocol for another month a fourth month after that but if the pain is pretty much gone if it's 90 or 95 gone from the baseline that it was when you started the protocol then at that point you can probably safely segue at least begin to segue back into your normal training routine and at this stage it will be very very important to break yourself back in properly start off with your normal training exercises much lighter than you think to than you think you need to and slowly build them back up over time because if you do too much too soon then you may just re-injure the tendon all over again or you may find the pain starts to slowly creep back in and you don't want that you don't want to erase everything that you just did remember three months in the grand scheme of things is really not all that much time so start off conservatively here and gradually rebuild over time and if you're an athlete be sure to start off with low intensity sprinting and jumping variations don't just jump full bore back into super intense explosive movements but if you heed my advice here then you probably will be back to your old strength and old explosive levels in no time and this time you'll have a healthy remodeled and pain-free tendon and like i said in the grand scheme of things this really isn't too much to ask it's really not too much time at all to put into getting yourself healthy again right and if you let your tendinopathy get so bad that you have to stop training the affected area all together well whose fault is that anyway either way now you know i've completely cured many a tendinopathy with this protocol and taken tendons with incredibly low load tolerance back to 100 functionality again absolutely no pain and total functionality in terms of low tolerance both with low speed strength movements and high speed explosive movements just remember to use the pain as your guide that's one of the most important things i can tell you in this video if the pain is continually trending downward then you're stepping in the right direction you're causing more positive stimulation to the tendon then you are negative degradation on the other hand if the pain is continually trending up even just slightly then you're likely causing more breakdown of the tendon and the remodeling process is not taking place effectively so use the pain as your guide remember that be consistent with your rehab be honest with yourself about how you're feeling about how your tendon is feeling take notes in a journal if you have to to keep yourself honest and focus on controlled movement and gradually increasing the exposure to load on the tendon over time if you can follow these steps then you will be rid of that lingering tendinopathy once and for all anyway that's all i got for today guys i hope you enjoyed it i hope you find it helpful if you have your own tendinopathy i hope you're able to take something useful away from this video if you know somebody who's been struggling with tendinopathy be sure to share it with them as well don't forget to hit the like button don't forget to subscribe to my channel and definitely leave me some love in the comments down below as well and if you're interested in online coaching or training programs be sure to visit my website www.incareleapfitness.com for more details keep training hard and i will catch you guys next time [Music] [Music] you