Podcast #117: Patellar & Achilles Tendon Rehab with Stefan Valdes


“Physical therapy, strength and conditioning. It’s just a spectrum.”

Unsuccessful NBA player with patellar tendinopathy: “I don’t think we were loading him up enough. We thought high load was a heavy isometric long duration.”

“All these contacts from the ground, which is pretty much what degrades the tendon if the tendon isn’t strong or resilient enough… so we do the exact opposite, stop playing for a little bit to allow your body to catch up.”

“We see a large variety of patellar tendons. Some players are curving in, out, some are really short, really long.”

“We see a lot of plantaris-related Achilles tendinopathy.”

“We pretty much do the same if it’s on the patella pole or tibial tuberosity.”

“Some people have a shorter free Achilles tendon, those are more explosive guys.”

Tendon adaptation: “If you can do a long duration isometric 45-seconds, how heavy is that weight?”

“A defensive back will have more patellar tendinopathy issues than a wide receiver because they’re always back pedaling in that crouched stance versus a receiver is going forward.”

“A defensive lineman, I see a lot more Achilles. I don’t see many in offensive lineman.”

“These kids coming in very significant patellar tendinopathy… they don’t do any strength training, they’re doing these AAU circuits… typically they won’t feel any symptoms until much later, but the damage has already been done.”

“It’s much easier to prevent tendinopathy than it is to manage it.”

“The AAU culture is just destroying these kids.”

“Some of these kids are coming in with worse tendons than these NBA guys.”

Lifting workouts for tendon rehab: “These sucks. These guys are in here sometimes for 2-hours. They’re terrible, but it’s what works for the tendon. They feel no pain eventually towards the end of the off-season… we modify it the following year because maybe they don’t need as much load as they did previously, especially if they maintained it during the season.”

“In general, the loading is a lot more than what people think.”

“If they have no tendinopathy issues, they’re not doing the same volume as someone who does.”

“BFR helps a lot with pain… let’s just increase work capacity in those muscles.”

Achilles: “We do a lot of heavy force isometrics for 3-5 second range, change the position of the foot angle, straight, in out, same thing on the seated calf.”

“From what I’ve seen, the heavy slow resistance, the heavy force isometrics do a lot more to tendon structure than a 30-45 second isometric.”

Stefan’s Instagram: https://www.instagram.com/dr.stefanvaldes/?hl=en

Movement Lab Training: https://www.movementlabtraining.com