Tendon pain remains a clinical challenge. It is recalcitrant to treatment, frequently recurs and often becomes bilateral. Whilst the cornerstone for treating tendinopathy is exercise, we do not understand the mechanism behind its effectiveness. The success of intervention studies that aim to improve tendon pain and function appear to be unrelated to change in tendon structure on imaging. If we look outside the tendon, we have previously shown maladaption of motor control and large amounts of motor inhibition in people with patellar tendinopathy and that these changes may be positively altered with specific training. Maladaptive changes to motor control and motor inhibition may be potential contributors to recalcitrance if our interventions fail to address them. It is unlikely that our current exercise prescription in tendinopathy actually addresses these motor control changes. If we look to the strength training and motor control literature, our protocolsmaybe lacking the specific features required to induce change. It is possible our approach to tendinopathy needs to include a better appreciation of motor control, the central nervous system (CNS) and changes that occur, termed neuroplasticity and most importantly, how to influence them. We present a new concept in tendon rehabilitation and explain the basis behind the specificity of training and instruction. Tendon neuroplastic training (TNT) combines the successful clinical protocols for treating tendinopathy, however with a strong focus on modulating the CNS and neuromuscular control with the goal of inducing neuroplasticity. The effect of different types of muscle contractions (isometric, isotonic – both concentric and eccentric phase) on the motor cortex activation is explained. The specific features of the TNT protocols will be discussed including simple methods of inducing neuroplasticity in exercise prescription for the clinician.
|Number of pages||1|
|Journal||Journal of Science and Medicine in Sport|
|Publication status||Published - Dec 2014|
|Event||Be Active Sports Medicine Australia National Conference 2014 - Canberra, Australia|
Duration: 15 Oct 2014 → 18 Oct 2014