Tendinopathy: AI-Powered Personalized Rehabilitation Program
How to return to training after tendinopathy?
The key is progressive loading: start with isometric exercises, then eccentric exercises, while gradually increasing volume. An AI program like Smart Rabbit automatically adapts intensity based on your pain and progress, avoiding the main pitfall: doing too much too fast.
Understanding Tendinopathy
We used to talk about "tendinitis," but this term is now outdated. Research has shown that most chronic tendon pain does not involve active inflammation ("-itis"), but rather a degenerative process: tendinopathy.
Tendinopathy vs Tendinitis
- Tendinitis: Old term suggesting acute inflammation (rare in reality)
- Tendinopathy: Modern term describing structural changes in the tendon
- Implications: Rest alone is not enough, the tendon needs progressive loading
Common tendinopathies in athletes include: patellar tendinopathy (knee), Achilles tendinopathy, rotator cuff tendinopathy (shoulder), and lateral epicondylalgia (tennis elbow).
Rehabilitation Principles
Tendinopathy rehabilitation is based on a fundamental principle: tendons need to be loaded to heal. Complete rest weakens the tendon and delays recovery.
The 4 Phases of Rehabilitation
- Phase 1 - Isometric: Static contractions without movement (5-6 weeks)
- Phase 2 - Isotonic: Slow controlled movements (4-6 weeks)
- Phase 3 - Eccentric: Focus on the lengthening phase (6-8 weeks)
- Phase 4 - Return to Sport: Plyometrics and sport-specific movements
Why Isometric First?
Isometric exercises have a pain-relieving effect on tendons. A 45-second contraction at 70% of your maximum can reduce pain for several hours. They also stimulate tendon repair without creating additional stress.
The Importance of Eccentric Work
Eccentric exercises (resisting while the muscle lengthens) have been proven effective for tendinopathies. The Alfredson protocol for Achilles tendinopathy, for example, involves 180 eccentric repetitions per day for 12 weeks.
How AI Adapts Your Program
Smart Rabbit uses artificial intelligence to create a personalized rehabilitation program that evolves with your progress.
AI-Based Adaptations
- Volume: Automatic reduction if pain increases, progressive increase if stable
- Intensity: Careful management of loads and RPE
- Exercise Selection: Gradual progression from isometric to plyometric
- Recovery: Extended rest periods for affected areas
- Compensation: Working other muscle groups while respecting the injury
The algorithm takes into account your feedback: if you report increased pain, the program automatically reduces the load on the affected area while maintaining activity on the rest of the body.
The Pain Rule: 0-3 Acceptable
During rehabilitation, some pain is acceptable. The generally accepted rule:
Pain Management Scale (0-10)
- 0-3: Acceptable, you can continue
- 4-5: Reduce intensity or volume
- Above 5: Stop the exercise and consult
- Next day: Pain should not be higher than before exercise
Mistakes to Avoid
Common Mistakes
- Complete rest: Weakens the tendon and delays healing
- Too fast return: Returning to previous load without progression
- Ignoring pain: Training through significant pain worsens damage
- Skipping phases: Moving from isometric directly to plyometric
- Stretching too hard: Aggressive stretching can irritate an already sensitive tendon
- Anti-inflammatory overuse: NSAIDs can slow long-term healing
Patience is essential. Complete tendinopathy rehabilitation takes 3 to 6 months, sometimes more for chronic tendinopathies. Wanting to go faster often leads to setbacks.
Key Takeaways
Summary
- Tendinopathy is not tendinitis: Structural degeneration, not inflammation
- Loading is essential: Complete rest is counterproductive
- Follow progression: Isometric, then isotonic, then eccentric, then plyometric
- Listen to your body: Pain 0-3 acceptable, above 5 stop
- Be patient: 3-6 months minimum for complete recovery
- AI helps: Automatic adaptation based on your feedback
Tendinopathy rehabilitation is a marathon, not a sprint. With a progressive and adapted approach, you can return to full activity while building an even stronger tendon.
Start Your Adapted Program
Smart Rabbit creates a personalized program that takes into account your tendinopathy and adjusts automatically based on your progress.
❓ Frequently Asked Questions
What is the difference between tendinopathy and tendinitis?
Tendinitis suggests acute inflammation, but research shows most chronic tendon pain is due to tissue degeneration (tendinopathy), not inflammation. Treatment differs: rest alone is not enough, the tendon needs progressive loading to regenerate.
How long does tendinopathy rehabilitation take?
Complete rehabilitation typically takes 3 to 6 months, sometimes longer for chronic tendinopathies. Patience is essential: trying to go too fast often leads to setbacks.
Can I continue training with tendinopathy?
Yes, but in an adapted way. Complete rest weakens the tendon. The key is finding the optimal load: enough to stimulate regeneration, but not excessive. Follow the 0-3/10 pain rule during exercise.
What exercises should I do for tendinopathy?
The recommended progression is: isometric exercises (static contractions), then slow isotonic, then eccentric, and finally return to dynamic movements. Each phase lasts 2-6 weeks depending on your response.
How does AI adapt the program for tendinopathy?
Smart Rabbit automatically reduces volume if you report pain above 3/10, suggests alternatives to problematic exercises, adjusts tempo (extended eccentric phases), and progressively increases load when sensations are good.
👨💼 About the author
Smart Rabbit - AI-powered fitness assistant helping you train smarter and recover better.