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Discussing the application of Progressive Angular Isometric Loading (P.A.I.L.’s)™ for tendon regeneration

October 11, 2011

In this video we discuss the concept of utilizing the P.A.I.L’s technique (Progressive Angular Isometic Loading) for the rehabilitation of tendonopathy.  More specifically, we discuss the application of tissue loading strategies to influence protein production, fibroblastic activity, and collagen deposition.

Related articles discussing P.A.I.L.’s:

–  Progressive Angular Isometric Loading (P.A.I.L.’s)™ exercises for Lateral Epicondylosis

–  P.A.I.L.’s™ exercise for rehabilitation of Plantar Fasciitis 

–   Diagnosis and Management of Tendinopathies – a review a presentation by Craig Purdam 


2 Comments leave one →
  1. October 23, 2011 11:12 pm

    With the PAIL’s for the Pateller Tendonosis do you recommend closed chain vs open for the eccentric loading (ex. single leg squat vs seated leg extension machine)? My instincts say closed for eventual return back into sport but does the desired effects (protein synthesis, collagen restructuring etc) occur with the open chain work?


    • October 24, 2011 2:09 pm

      Hi Greg
      When prescribing PAILS exercises, both open or closed chain exercises will work. The main reason for closed chain is to decrease joint shear (as well as to make the movement more functional). However when we are dealing solely with re-building the tendon, the functionality of the movement is less important…further regarding the shearing, because they are isometric exercises, this negates the inherent stress of OKC exercises. As you noted however, there will be a return to CKC training as soon as the tendon is healthy enough to sustain load throughout a full range of motion.

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