Why Your “Tear” Might Be Normal (and how to fix it)
If you’ve recently had an ultrasound or MRI on a painful shoulder, hip, or heel, you may have been confronted with words like “severe degeneration,” “thickening,” or “tears.” For many patients, these results cause immediate fear.
However, at Bodyreform, we look at the person, not just the picture. Clinical evidence shows that tendon changes are a natural part of aging—much like grey hair or wrinkles.
The Imaging Reality Check:
- Commonality: Rotator cuff tears are common in most adults over 60, and Achilles/gluteal issues are frequent in active adults aged 40–70.
- No Pain, No Problem: Many people have “tears” on imaging with zero pain.
- Not a Predictor: A scan showing “degeneration” does not predict a poor recovery. Your tendon is not “damaged beyond repair”—it simply needs its load tolerance restored.
Understanding the Stages: Why “Rest” Often Fails
Most tendon pain in people over 50 is Degenerative Tendinopathy. Unlike an acute injury, this is usually not inflammatory. The collagen structure has simply become disorganized and the tendon has become weaker at handling your daily life or sporting loads.
Because it isn’t inflammatory, “calming it down” with rest, ice, or anti-inflammatories won’t solve the problem. In fact, rest alone reduces collagen stimulation and tendon stiffness, making you more prone to injury when you finally try to return to activity.
The “Bodyreform” Evidence-Based Loading Continuum
Tendons adapt slowly, so patience and precision are key. Emma and Sarah use a staged approach to guide you back to full function:
- Isometrics (60-second holds): This is our starting point for pain modulation. These static holds “quiet” the pain signal and initiate loading safely.
- Heavy Slow Resistance: This is the “Gold Standard.” We use Clinical Pilates equipment to build the strength and “stiffness” the tendon needs to support your body weight.
- Plyometrics & Fast Loads: For those returning to running, tennis, or skiing, we move into dynamic loading to ensure the tendon can handle “spring” forces.
The 24-Hour Monitoring Scale: Pain is Not Always Damage
One of the most important things we teach our patients is how to monitor their own recovery. We use a clinical “Monitoring Scale” to keep you moving safely:
- During Exercise: Pain up to a 3-4/10 is acceptable.
- After Exercise: Pain must settle within 24 hours.
- The Rule: Controlled pain during rehab loading is safe and often necessary for the tendon to adapt. Pain does not equal tissue damage.
Why Passive Treatments Are Only “The Side Dish”
Passive treatments like massage, needling, shockwave, or injections may reduce pain in the short term, but they do not rebuild tendon strength. * Injections: Repeated injections are actually associated with poorer long-term outcomes.
- The Truth: Exercise and guided loading is the primary treatment. Passive therapies are only adjuncts to help you get through the harder work of strengthening.
Ready to build a resilient tendon?
Tendons take time to change, and “boom-bust” cycles (doing too much, then resting too much) are the biggest barrier to recovery. Guided rehabilitation ensures you are loading at the correct intensity for your current capacity.
Book a Tendon Assessment with Sarah or Emma today — 09 361 6415]