• Crystal Hazelton, PT, OCS

You are more than a pelvic floor!

Updated: May 17, 2019

How many roles do you play each day? Honestly, I exhausted myself thinking of them all. One of my roles is social media coordinator, and I've been struggling to decide how to kick off this first blog. Do I talk about the pelvic floor, which is my subspecialty and all the rage on insta? Do I talk about more general tips and tricks? Do I focus on dance rehab or my other love hypermobility? Or do I geek out and spread the knowledge I gained from recent podcasts and article reviews on tendon pain? Well, I love it all! And this blog is going to follow my whims, just like I do IRL. And just as I wear many hats as a Mom/Wife/Daughter/Physical Therapist/Orthopedic Specialist/Pelvic Floor Specialist/Owner/Friend/Marketer/Office Manager/Housekeeper/School Volunteer/Dance Mom/Baseball Mom....this blog is going to touch on a myriad of topics with a common theme of improving women's health so you can stay active!

More Than Just the Pelvic Floor

When a tendon hurts, load it!

Health as a woman definitely includes the pelvic floor. But it also includes the entire rest of our body! One of the most common injuries I treat is a tendon injury, which can occur anywhere in the body that a muscle meets the bone. So, let's talk about tendon pain.


Who should care about it:

· Dancers

· Runners

· Tennis players

· Moms carrying heavy kid gear

· Anyone with repetitive strain injury

· Anyone with a pain that comes on a few hours after exercise

Many people will experience tendon pain at some point.

What is it?

Also known as tendinitis, tendinosis, tendinesis, tenosynovitis. If you want to sound well read, just change that word to tendinopathy, which is more of an umbrella term. A tendon is the tissue that connects your muscle to bone. Tendinopathy is an injured tendon.

What does it feel like?

A dull ache usually when moving. Sometimes the pain is delayed by a few hours after activity.


What causes tendinopathy?

1. Overuse & poor movement patterns.

2. Stressing the tendon more than usual. This is common for “weekend warriors” who aren’t strength training in between bouts of fun.

3. Stressing the tendon repeatedly because a joint above or below isn't aligned or moving well.


There's no beating the clock. Only avoiding restarting it.

How long does it take to get better?

2 months to one year. Managing total load makes that happen faster. Rapid excessive load (over stressing) the tendon is one reason it can take a longer time to heal.

Let’s say the outside of your hip was hurting, so you stopped running for a week. It feels better. Then since it feels better, you resume running and your hip pain flares again. Two mistakes just happened.

1. Complete rest without progressively strengthening the injured tendon.

2. Using pain as a guide to determine when healing is complete.

When the pain is calmed, it’s a good time to strengthen so the tendon’s load tolerance can improve. This does not happen in one week, in fact it takes 2 weeks for mild gains and 6-8 weeks for strong gains. Each time pain flares, the clock for healing starts all over. This is one reason why some get better in 8 weeks and some in 52. Precise exercise and activity prescription from Core Dynamics Physical Therapy and Wellness Inc will help you stay on track to avoid delays in healing.


How to fix it?

Progressive strength training for tendinopathies is all the rage with the latest research. The buzz phrase is actually “building load tolerance”. At different stages of an injury your tendon can handle different loads. Makes sense, right? “Rest” doesn’t mean lay down in bed. It actually means changing how you move so a tendon isn’t getting stressed or overloaded while it is healing over the first few weeks.

How do you do this, you ask? That’s where your PT comes in! I assess your alignment at rest and with activities. Then I teach modifications so you can keep the rest of your body in shape while protecting the healing tendon. As healing progresses, we now actually recommend appropriately loading your tendon. This means strengthening it. Why? A tendon is the part of the muscle that attaches to your bone. When you contract your muscles by lifting weights, you not only make your muscle bigger, you strengthen the tendon—allowing it to handle higher loads! Tendons are sensitive structures, like Goldilocks and The Three Bears, too little won’t help, too much actually makes it worse, your goal is to strengthen “just right”. The holy grail of what defines just right doesn’t exist because it depends on the situation. So instead of a certain weight, we recommend using an exertion scale & pain response to determine appropriate weight. Guess what, some pain is tolerated as long as it is less than a 3 point increase in pain on a scale of 0-10, eases after exercise, and doesn’t increase pain over the next 24 hours.

Sound complicated? That’s why I am here. I’ll do the thinking for you and give you a simple action plan over 6-8 visits spanning 8 weeks to improve your pain and get you back to your active lifestyle.

If you think you are experiencing tendon pain, call today for a free 20 min discovery session to see how Core Dynamics Physical Therapy and Wellness Inc can help you get back to your active lifestyle!



Articles to support this treatment philosophy:

Gluteal Tendinopathy https://www.bmj.com/content/361/bmj.k1662

Achilles Tendinopathy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658946/

Patellar Tendonitis https://www.jospt.org/doi/full/10.2519/jospt.2015.5987

Lateral Elbow Tendinopathy (Tennis Elbow) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094303/

#tendinopathy #tendonpain #weekendwarrior #tenniselbow #hippain #stayingactive #momstrong #morethanpelvicfloor #pelvicfloor

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