The phrase "no pain, no gain" is commonly heard in the gym, often uttered through the gritted teeth of muscular men and women as they hoist heavy metal. But the type of "pain" you feel during lifting is often just extreme discomfort, the muscles protesting as you challenge them to perform. Persistent pain in the tendons that does not go away with rest may indicate a condition called tendinosis, and failure to address it could lead to diminished performance and ongoing pain.
Tendon Anatomy and Function
Tendons are a continuous part of muscles that attach them to bones. During exercise, the tendon pulls on the bone as the muscle shortens, causing joint movement. While technically part of the muscle, tendon tissue is mostly made up of parallel bundles of collagen, with relatively few metabolically active cells. Because of their makeup, tendons require limited amounts of oxygen and nutrients, and have a limited blood supply. Mechanical forces like those applied during weightlifting stimulate tendon tissue growth.
Overload and Muscle Development
In order to elicit a training effect from weightlifting leading to muscle growth, you must apply the principle of progressive overload. According to Thomas Baechle and Roger Earle, authors of "Essentials of Strength Training and Conditioning," progressive overload means progressively placing greater than normal demands on muscles so they continue to adapt. Tendons also respond to overload by becoming stronger within the tendon body and at the junction where the tendon attaches to the bone. However, consistently overloading the muscles and tendons without adequate recovery time or performing exercises with improper technique can lead to painful overuse injuries.
DOMS vs. Tendinosis
In the days after a weightlifting session, it is not uncommon to experience aching muscles and joints, a condition known as delayed onset muscle soreness. DOMS is a normal physiological response to overload that peaks within 24 to 48 hours, then diminishes until it resolves, usually within 96 hours, according to Johnmichael Maes and Len Kravitz, researchers at the University of New Mexico. However, competitive bodybuilder and fitness expert David Ryan, M.D., warns that tendon pain persisting for longer than two weeks may indicate a more serious condition known as tendinosis. Tendinosis does not respond to and may even be irritated by typical treatments for muscle pain like rest, ice and anti-inflammatory pain medicine, according to Ryan.
Prevention and Treatment
To avoid injuries to the tendons, focus on good exercise technique. Move the joints through their full range of motion in a slow, controlled fashion. Do not generate momentum by engaging other muscles, and resist the force of gravity as you lower the weight. If you cannot control the weight in both directions, it is too heavy. If your health care provider confirms that you have tendinosis, Ryan recommends an active therapeutic approach for treatment. Steps include identifying which movements cause you pain, warming up the painful area using lighter weight loads and progressively faster repetitions, then gradually increasing weight and slowing repetition speed. Friction massage may help alleviate pain and speed recovery.
References
- Bodybuilding.com; The Truth about Tendon Pain: David Ryan, M.D.
- University of New Mexico; Treating and Preventing DOMS; Johndavid Maes and Len Kravitz, Ph.D.
- University of Michigan: BME/ME 456 Biomechanics --- Ligaments and Tendons Structure and Function
- "Essentials of Strength Training and Conditioning"; Thomas R. Baechle, Roger W. Earle; 2008
