By Adam Malek PT, DPT, SCS
In Part 1 of “Do Repetitions and Sets Matter?” we defined sets and repetitions and discussed the recommendations based upon training goal (i.e. building muscular strength, power, endurance, or hypertrophy). In today’s post, we are reviewing the principles of tissue healing and training considerations for when tendon, ligament, or cartilage injuries are involved.
THE BEST WAY TO STIMULATE TISSUE REPAIR in the case of an injury is to construct an exercise program that will deplete oxygen levels in the tissues. If the exercise is followed by rest and maintenance of high tissue temperature, vascularization and oxygenation will be stimulated to compensate for their relative depletion that occurred during the exercise. In other words, repeated exercise combined with relative rest periods restores the oxygen capacity of the tissue. Completing 1-2 weeks of this type of activity, restores tissue quality. With an acute injury, this restoration process may be even shorter. With overuse, it has been demonstrated that there is a significant decrease in pain over the first 2-3 weeks, but that tissue strength is not restored until 4-6 weeks after the exercises have been initiated. Depending on the severity of the tissue involved, your sets, reps, and load will need to be modified and healing time should be considered. As much as we would like to speed up healing, this should be considered when rehabilitating an injury:
CONSIDERATIONS WITH TENDON & LIGAMENT INJURIES: It stands to reason that when pain is present, the ability to load a tendon or ligament will decrease. It is vital to find a baseline training level that does not provoke symptoms. When a tendon or ligament injury is involved, consider the following:
CONSIDERATIONS WITH CARTILAGE INJURIES
Cartilage, such as the meniscus of the knee, is trainable. Current research demonstrates that the stiffness of cartilage can be improved. Thus, training decisions can modify cartilage extensibility. The stimulus for cartilage is compression/decompression preferably in a weight-bearing or functional position for thousands of reps. The question that remains is whether that modified tissue is of sufficient quality to handle normal functional loads. To reinforce these principles, your training should consider the following:
Come see MJP’s Sport Physical Therapist to maintain your training while receiving individual modifications to assist with your involved tissue.