Brain training to give tendon pain the boot

Forget mind over matter - it's mind over muscle that has the potential to stop recurring tendon pain. Researchers at the Monash University Tendon Research Group have now developed a...

Forget mind over matter - it's mind over muscle that has the potential to stop recurring tendon pain. Researchers at the Monash University Tendon Research Group have now developed a medication and injection free exercise that can eliminate kneecap tendon pain instantly - and it relies on brain power to do the heavy lifting.

Tendon pain in the knee has the potential to be debilitating and long-lasting. Elite athletes are among the major sufferers - the injury can sideline them or force them to give up their sport entirely. 

The new targeted exercise, tendon neuroplastic training (TNT), combines external brain stimulation with static strength training, such as doing exercises to the sound of a metronome. Unlike movement-based treatments, which often just increase tendon pain, TNT is painless. 

The project’s lead researcher, Dr Ebonie Rio, said the athletes she treats can complete TNT during training without worry of muscle fatigue. The exercises have even been found to increase muscle strength by up to 19 per cent immediately afterward.

“More than 50 per cent of people who stop sport because of tendon pain still suffer from that pain 15 years later. Our simple exercise is revolutionising how tendinopathy is treated,” Dr Rio said.

The researchers found that a single, heavy bout of the exercise eliminated kneecap tendon pain instantly, lasting for up to 45 minutes. During the exercise, muscles are ‘on’ without being extended, and the joint is kept still – for example, holding a weighted leg-extension in one spot.

The treatment has been successful with a wide range of athletes, from football players to ballet dancers.  Darren Minchington from the AFL club St Kilda and Adam Bull, principal dancer at the Australian Ballet, are among those who have been successfully treated.

Dr Rio said that the current exercises used to combat tendon pain don’t do enough to address the way the brain talks to muscles, which may be part of the reason why tendon pain is so persistent and often comes back.

 “We have no idea what’s happening at a tendon level with tendon pain. Despite the fact that it can be chronic and persistent, it behaves quite differently to other types of chronic pain – for example back pain – in that it’s very localised within the tendon.”

Dr Rio will continue to test the treatment on other tendons, as well as finding the minimum number of repeats needed to get lasting effects from the exercise.