Tendon injuries are very common and often hard to rehab correctly. Strengthening is part of rehab but it has to be right to get the right results.
Tendon strength is different to muscle strength. Tendons don’t really grow in size like a muscle. Tendons have to absorb tension and release it again at the correct time like an elastic. The stiffer the elastic the better the return of energy.
One of the reasons for the high rate of injury is that strength, power, and speed are dependent on stiff connective tissues (tendon, ligaments). Stiffer tendons may be better for performance but they are also more injury prone.
It is possible to make tendons stiffer through plyometrics which help speed, strength and power, but stiffer connective tissues can contribute to higher rates of injury to the attached musculature. The stiffness of a connective tissue, like a tendon or ligament, is dependent on two main factors:
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the collagen content
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the amount of crosslinks within the collagen.
Crosslinks increase when athletes train at a high speed or with rapid changes in direction.
Crosslinks decrease when using strength exercise with slow movements. Increasing slow contractions are optimal for improving tendon health and incorporating slow contractions into a rehab program can decrease time away from sport (return to play).
Unlike muscle, connective tissue cells adapt quickly to exercise. To get maximal effects you only need 5-10 minutes of activity. You then have to wait another 6 hours before the tissue becomes responsive again.
An example of a rehab program would be exercising for 10 min 3 times per day with 6 hours in between sessions.
Dr Baar a tendon rehab expert and researcher also shows evidence that eating gelatin and vitamin C may promote greater collagen production, especially following a tendon/ligament rupture. (5g gelatin, 500mg vitamin, 30-60min before exercise).
Apart from these specific exercise and feeding regimes, the recommendations for protein intake are similar to those in muscle:
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20g of high quality protein (0.3 g/kg/meal) at EVERY meal
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Protein intake around rehab sessions
Dr Baar also warned that following forced inactivity the tendons lose their compliance near the muscle end. This may actually make players who return from injury slightly faster but it makes the muscle much more prone to injury. It is important therefore to monitor and manage the training load.
For more info on tendon rehab check out www,mysportscience.com