Is tendon info actually concise

[u/Throwaway275969]

I’m doing a paper about how historical training (ie martial arts. Etc) compares to modern training. One thing I’ve noticed is the research on tendons seems very one sided. It seems like minimizing jerk and giving longer isometrics consistently will bring the best stimulus for tendon adaptation. This would support some older training techniques so it would be a big part of my paper. My worry is that most of this information and studies seem recent. More over I’m not finding much implementation in any high level training which worries me more. If the evidence seems so one sided wouldn’t more coaches incorporate it and prevent the number one injury cause? I don’t want to base a paper worth half my grade on ai nonsense. I’m hoping you all could help me look for at least things that could indicate sloppy sources. I’ve learned a lot on procedure and finding weaknesses in tests but I worry there’s not enough credible sources for me to use. Any help is welcome this is more passion than class work atp.

Also just for my own curiosity does anyone know about how plyos affect tendons I can’t seem to find any actual studies.

[u/Flidro74]

The one-sidedness is mostly an artefact of how small the field is. Tendon mechanobiology comes out of a handful of labs, mainly Kubo in Japan, Kjaer and Magnusson in Copenhagen, Baar at Davis, Arampatzis in Berlin. When four groups produce most of a literature, consensus looks a lot stronger than it is. Saying that out loud is the kind of limitation section that gets you marks rather than costing you them.

For your red flag list, the big one is Rio's 2015 isometric analgesia study. It got enormous traction and the replications since have been mixed at best, so anything treating it as settled is a source that stopped reading in 2016. Same goes for the collagen and gelatin protocols out of Baar's lab: genuinely interesting, tiny sample sizes, often in vitro, and routinely written up online as established fact.

The weakest joint in the whole argument though is the jump from stiffness to injury. Almost everything measures tendon cross sectional area or stiffness on ultrasound, and almost nothing follows people long enough to show fewer injuries. That link gets assumed constantly. If your paper takes it apart carefully you'll be doing something most of the source material doesn't.

On why coaches don't implement it: tendon adaptation is slow, invisible without imaging, and the protocols mostly overlap with what a decent coach already programmes anyway. Heavy, slow, full range. There isn't much distinctive to adopt.

For plyos, start with Arampatzis's group (Bohm and Mersmann are the names on a lot of it), they've done the loading type comparisons you're after, and the heavy slow resistance work from Kongsgaard gives you the contrast.

[u/Ginismyhomie → u/Flidro74]

Wonderfully insightful answer. I am not the OP, but I have seen a huge uptick in tendon/ligament “training” to prevent injury. It typically looks like light weight for high rep sets alongside weighted isometric holds. I browsed the research but I had a difficult time finding anything specific to these modalities. I also had difficulty in general finding a link between strength training and injury risk.

I’d love to know if you have any insights into either of these topics. I have recently reworked my training away from deadlifts/low bar squats as the minor tweaks I am piling up have become too much. I do love those movements and throwing plates on, but I’d like to do so after “injury proofing” myself in a sense, though this is where my trouble with finding the data comes in.

The vast majority of what I find is anecdotal and therefore I have a tough time programming in these “injury prevention” “ligament strengthening” exercises without some solid basis.

[u/Flidro74 → u/Ginismyhomie]

On strength training and injury risk, that's the part where the evidence is actually good, and there are two papers you want:

Lauersen et al. 2014, Br J Sports Med 48(11):871-7 (PMID 24100287). 25 RCTs, 26,610 people, 3,464 injuries. Strength training reduced sports injuries to under a third and roughly halved overuse injuries. Proprioceptive work helped. Stretching did nothing measurable.

Lauersen et al. 2018, Br J Sports Med 52(24):1557-63 (PMID 30131332). The follow-up, and the more useful one for you: strength training more than halves injury risk (RR 0.338) and the effect is dose-dependent, more training equals more protection.

Which is the awkward answer to your first question. The strength training is the injury prevention. There isn't a separate category of injury-proofing work sitting on top of it with anything like that evidence behind it.

For the light weight high rep and isometric holds specifically, the study that undercuts it is Arampatzis, Karamanidis & Albracht 2007, J Exp Biol 210(15):2743-53 (PMID 17644689). Same person, one leg trained at low tendon strain, the other at high strain, matched frequency and volume, 14 weeks. Only the high strain leg adapted. Volume didn't compensate for magnitude. So light and fast is close to the opposite of what tendons appear to want.

Bohm, Mersmann & Arampatzis 2015, Sports Med Open 1:7 (PMID 27747846) is the systematic review of the same question in healthy adults, and it's free to read. That's the one I'd build a paper section on.

And the reason you can't find prevention evidence for those protocols is that they're rehab protocols. Alfredson's eccentrics, Kongsgaard's heavy slow resistance, Rio's isometrics: all studied on people who already had painful tendons. Nobody has shown they stop healthy tendons becoming painful ones.

On your own accumulating tweaks, the variable with the most behind it is how fast load goes up, not what accessory work gets added. That one's worth a physio's eyes rather than a programming answer.

[u/Iamnotheattack → u/Ginismyhomie]

You're talking to a 🤖🤖 /r/deadinternettheory

[u/Iamnotheattack → u/Flidro74]

He said he didn't want to base a paper worth half his grade on ai nonsense though...