Weights, resistance bands and rest are better than bodyweight exercises to heal tendinopathy

Adapted from BMJ 4 May 2024 Weights, resistance bands, and rest days are best for tendinopathy.

A systemic review and meta-analysis by Pavlova and Shim, published in the Journal of Sports Medicine 2023, indicates that planned exercise using weights or resistance bands with rest intervals gives better results than exercising every day, particularly with body weight exercises.

People with diabetes are considerably more prone to tendinopathy than the general population, so these findings may be helpful to them.

Tendinopathy is diagnosed when tendons become painful, stiff or swollen. It can affect both adults and children and tends to occur in the Achilles tendon at the heel, shoulder, elbow, knee and hip.

Although exercise is recommended it hasn’t been clear what specific exercises help the condition and what the training pattern should be to maximise effectiveness. Improving disability, function, pain, movement and quality of life are important for people who suffer from these conditions.

This study included 110 studies covering 4,000 people from Europe, Australia and the USA. Most of the exercise regimens had been prescribed or delivered by physiotherapists.

The study found that people improved more if they used dumbells, loaded backpacks or resistance bands rather than bodyweight only in resistance exercises. Also, rest days between sessions gave better results than daily exercises. The results were the same no matter the tendon damage site.

The authors suggest that at least one day of rest between the exercise sessions is necessary to maximise improvement. The number of repetitions and sets necessary did not become clear after the analysis.

My comment: So many people suffer from musculo-skeletal pain and research like this is very helpful. I’m a daily exerciser and I found that my chronic back pain got better by having more than one day between intense resistance workouts. Previously it had been alternate day resistance exercise alternating with either aerobic exercise or yoga/stretching. So many of us have the idea that more is better when really we would be better off doing less. Weights and resistance bands give more flexibility regarding the force exerted on the muscle and tendon so may lend themselves to progressive overload than body weight exercise.