FRP: BUILDING STRONG TENDONS AND LIGAMENTS

Tendons and ligaments – terms often confused and used interchangeably - are two different structures found in and around joints that, although similar, serve different roles.

Tendons connect muscle to bone. The most well-known tendon, the Achilles tendon, connects the gastrocnemius and soleus (the two calf muscles) to the calcaneus (heel), and facilitates movement involving the pointing of the toes. Every time you walk, and you push off the toes of the back foot as you take a step, you can thank the Achilles for allowing that to happen.

Ligaments play an important role in holding our bodies together, as they are most commonly found connecting bone to bone when they meet at a joint. These ligaments keep our bones in place, allowing smooth movement without dislocation. The cruciate ligaments in the knee, for example, connect the femur (thigh bone) to the fibula and tibia (shin bones) which prevent the upper leg from going in a different direction to the lower leg.

Injury Risk

"First responders require strong and resilient tendons and ligaments that will not only stay healthy but also facilitate high levels of performance at a moment’s notice."

Injuries to tendons and ligaments make up a large portion of soft tissue injuries, which account for roughly half of all reported injuries suffered by Australian first responders. As a first responder, you are frequently asked to move suddenly, unpredictably, and forcefully in unfamiliar environments full of hazards, which all contribute to place large amounts of stress on the ligaments and tendons throughout the body.

Common injuries to tendons include tears (strains), ruptures, and chronic or acute inflammation or degeneration referred to as tendinitis, tendinosis or tendinopathy. These injuries occur most commonly from acute trauma, overuse, poor mechanics or sudden load. Ligament injuries are typically a result of twisting, pulling or impact that causes the ligament to stretch and tear, which can result in mild (stretching), moderate (partial tears) or severe (rupture or complete tear) injuries.

Recovery can be as short as a matter of weeks for a minor injury, or years for something chronic. They will most likely require diligent strengthening and conditioning within the recovery window and unfortunately may still never return to 100% function. Therefore, for a career in the emergency services where your health is your greatest asset, injuries can not only affect your physical health, but also your financial and mental health, and overall wellbeing.

First responders require strong and resilient tendons and ligaments that will not only stay healthy but also facilitate high levels of performance at a moment’s notice. When duty calls and you’re required to sprint, jump or push, a rupture is more than a severe injury – the consequences could be catastrophic for yourself, your partner, or the public.

Building Strong Ligaments and Tendons

Training ligaments and tendons to cope with these intense demands is relatively simple, but the methods that target them are likely to be missing from the average training program. Controlled eccentric movements, heavy loading, isometrics, and explosive plyometrics all help to create stiffness, resilience, and elasticity in tendons, and strength and tissue density in ligaments for maximum performance with decreased injury risk.

• Heavy Loads

  
  

Heavy resistance training is most likely in your training program already, and it’s a great place to start for tendon and ligament strengthening as it helps to build all connective tissues. ‘Heavy’ refers to 80%+ 1RM and the most suitable lifts will be bigger compound lifts such as squats, bench presses, overhead presses, pull ups and deadlifts.

Heavy loads don’t have to be done in isolation – you can combine your heavy strength training with one of the other tendon and ligament training methods such as controlled eccentrics.

• Controlled Eccentrics

The majority of lifts will have two movement phases, the concentric and the eccentric. The concentric phase occurs when the muscle contracts and moves the weight, and the eccentric phase occurs when the muscle lengthens to control the weight into a position where the concentric phase can restart. For example, the concentric phase of the bench press is pushing the bar off the chest into full extension of the arms, and the eccentric phase is the lowering of the bar back to the chest.  

Slow eccentric movements are a great way to load tendons and are useful in the rehabilitation phase of a tendon injury, but also when used preventatively as they help to increase tendon stiffness. This can be achieved by either increasing the eccentric load time to 3-5 seconds, or by incorporating eccentric-only movements like Nordic hamstring curls or pull-up negatives. Typically, the eccentric phase can be loaded more than the concentric phase, so eccentric-only movements are also a great way to build general strength.  

• Isometrics

There are two types of isometrics – overcoming and yielding, and both are important for building strong and resilient tendons and ligaments. Yielding isometrics are the most common and feature in most group fitness classes. They involve holding load in a fixed position, and include exercises such as a plank, squat hold or wall sit. Overcoming isometrics are far less common and involve exerting force against an immovable object. A bench press overcoming isometric, for example, involves pushing a barbell with maximal force against spotter arms placed somewhere within the bench press range of motion – typically around 90-degrees of elbows flexion.

By including both methods, you’ll not only develop the maximal stiffness, force output, and capacity, but also endurance without too much next-day fatigue. Be aware, however, overcoming isometrics are taxing on the Central Nervous System, so they should only be completed every few days for the average lifter.

• Explosive Plyometrics

The stretch-shortening cycle is a key part of any ballistic movement, and it involves the lengthening and then sudden contraction of muscles to propel the body during explosive movements such as sprinting and jumping. The plyometric itself helps to improve the tensile strength of tendons, allowing them to handle more force applied by the muscle, but majority of plyometrics will have a landing phase which is equally important.

At the end of any plyometric jump, you have to safely land to complete the movement. The landing phase helps both tendons and ligaments become more resilient by improving overall force absorption which also contributes to lowering the risk of injury when an external force – such as a violent offender – is applied to the body.

Explosive plyometrics are a great way to start a workout after a low-intensity warm-up, because they also prime the central nervous system for any heavy lifting that might follow.

Sample Session

A full-body session focused on injury prevention and tendon and ligament strength might look something like this:

This session plan, while hitting all of the important training methods for building resilient and high performing tendons and ligaments, will also make you stronger, faster and less prone to injury. As a first responder, it’s important to ensure you’re maximising the time you spend in the gym by planning sessions that will actually transfer to the field and – more importantly – life.

Summary

When you’re required to perform under sudden, unpredictable, and sometimes extreme conditions, you want to know you can rise to the occasion. By incorporating heavy resistance training, controlled eccentrics, isometrics, and explosive plyometrics, you can improve tissue stiffness, strength and load tolerance – qualities that will help you stay injury free and increase operational performance.

These methods will also go a long way to future-proofing your body, ensuring you can continue to live life without limitations in retirement and beyond. Investing in your connective tissue health is ultimately an investment in your safety, career longevity and overall wellbeing.