Bill W. Brazil Blog: Dear Mark: Tendon Edition

Dear Mark Tendon Edition in line Last week, I told you how to strengthen your tendons and improve their resilience to strain and injury. You had a lot of questions in the comment section. For today’s edition of Dear Mark, I’m answering some of them. First, can Dan John’s “Easy Strength” program work for bodyweight training? Probably, and I give my suggestions on doing so. Next, what’s the deal with meniscus tears—mild ones? Can you heal them yourself? Are there any exercises that help the process? And finally, can the tendon exercises I discussed in the original post help folks with carpal tunnel syndrome?

There were some other questions about nutrition for tendon health, which I’ll cover in a future post. Don’t think I’m ignoring them.

Let’s go:

How would you apply the principles of the Easy Strength program to body weight exercises? Just reduce the reps? This is coming from a sedentary 46 year old beginner who is thinking about getting started.

John

Yeah.

As I understand it, the Easy Strength program was meant for long time lifters who were sick of getting bogged down in the details, the type of people who’d jumped from program to program in search of the optimal way to train and in the process of stressing out over it actually stopped training. Easy Strength just boils things down and makes training a lot easier (both physically and mentally). It removes the guesswork.

For an untrained sedentary middle aged guy, bodyweight “Easy Strength” is great.

Pick five movements to do every day:

A knee flexion exercise (squat, lunge, single leg squat, etc).

A hip hinge (deadlift, kettlebell swing, etc; this generally requires a weight so bodyweight may not work exclusively).

A press (overhead, pushup, dip, handstand pushup).

A pull (pullup, row).

A loaded carry (again, you need an external weight for this, but it doesn’t have to be a dedicated piece of exercise equipment; a heavy bag of books or a sack of sand work).

For each movement, assess your max reps. Go to failure on each, note how many reps you managed, and cut them in half for your work sets. So if you can only do 30 pushups in a row max, do 4-5 sets of 15 each day. If this rep scheme is still too hard to do every day, reduce by a third (15 reps becomes 10). Remember, it should be “easy,” not difficult. Your reps should “pop.”

As you progress, you can add weight by wearing a weighted vest or using weighted implements around the house. Load up a backpack with heavy books. Carry your kid or spouse.

Can you advise about slight lateral tears in meniscus? I’m 62, just started weight lifting this year and seem to have injured my right knee – but not badly enough for surgery. Any suggestions for strengthening?
Thanks,

Peg

Movement, movement, movement. Wait, let me amend that: pain-free movement, pain-free movement, pain-free movement.

Just keep moving, exercising, and training. Do everything that doesn’t hurt.

Low-or-no-resistance cycling. It’s boring but it works. Motion is lotion. Get a good book or podcast going and hit the bike.

Knee circles (see this great post by my buddy Angelo Delacruz).

Dick Hartzell’s knee rehab exercises. You’ll need some bands.

Focus on strengthening the hamstrings, glute medius, and glute maximus.

Basically, the entire posterior chain tends to be weaker in people with knee issues.

Hamstrings: Romanian deadlifts are great for this, and much simpler than they look.
Glute medius: Lie on your side and lift your leg up to 45 degrees. Stay fully extended at the hip. Don’t go into flexion (don’t bend). Aim for 3 sets of 20 reps on each side.
Glute max: Try glute bridges. Both weighted and unweighted, single leg and double leg. Hip thrusts (eventually with a weight across your hips) are also great for the glute max.

Squatting with different stances. A fun drill is to scatter a handful of coins across the floor. Then, using the position of the coins as a guide (a la Twister), squat down in various stances (wide, narrow, stagger, lunge, etc) to pick them up. Again, avoid pain.

Standing up from a cross-legged sitting position without using hands (and going back down). See this link. Make sure you can do this without pain. It’s a great way to condition the connective tissues of the knee.

Walking on various parts of your feet. Sounds weird but it hits your tissues at different angles. Walk on the outside of your feet. Walk on the inside. Walk on your heels. Walk on the balls of your feet. Walk with your feet turned out and in. Do this on sand. Do it barefoot as much as possible.

If you hurt yourself lifting weights, consider finding a good trainer for a few sessions until you get the hang of it.

The good news is that tears on the outer edges of the meniscus do receive blood flow and can heal themselves. Check everything out with your doc/PT before trying them, but I think you can make very good progress. Good luck!

I wonder if/how some of these exercises could help prevent certain other repetitive use injuries, like carpel tunnel. If the surrounding tendons are stronger/more supportive, maybe it’d have some protective benefit. Just thinking out loud

Ashley

The carpal tunnel is a big causeway in the wrist for the median nerve and tendons to pass through on their way to the fingers. In healthy wrists, there’s a lot of movement through the tunnel. Every time you flex a finger or bend your wrist, that nerve and those tendons slide through. They should slide through smoothly. In carpal tunnel syndrome, they don’t. The median nerve doesn’t glide in carpal tunnel; it gets stuck and stretches. This is painful and can even restrict the function of your hand.

The physical therapy treatment for carpal tunnel with the most evidence behind it are probably nerve glides.

Here’s a good basic description and video of them. Or try the following a few times a day:

Sweep your arm out to the side until it is slightly behind you, palm facing forward, elbow gently straight
Pull your wrist back until you feel a gently tension somewhere in the arm
Relax the wrist forward until tension is relieved
Repeat 10 times

Ease the tension on the wrist to about half
Holding this position, gently raise your arm until you feel tension (stay below shoulder height)
Lower the arm until tension is relieved
Repeat 10 times

Ease the tension on the arm to about half
Tilt your head (bring opposite ear towards opposite shoulder) until you feel tension
Straighten the neck until tension is relieved
Repeat 10 times

As a major cause of carpal tunnel syndrome is repetitive motion, or keeping your wrist stuck in that “poised over keyboard” position, wrist mobility training can really help. Try Mobility WOD or wrist yoga.

Play around with some self hand-massage, too. Really dig into any tender spots to break up adhesions that could be inhibiting proper nerve movement.

That’s about it, folks. Thanks for reading, thanks for asking questions, and thanks for assisting with your own input down below in the comment section.

Take care!