Load Management

What does it mean?

Load management is a medical term that is often used by physiotherapists when talking about adjusting or modifying something that causes you discomfort. It is used most often when talking about tendon-related discomfort.

I’m still not sure what it means.

Often, when you have something that is uncomfortable such as a tendon complaint (but can include lots of other muscle and joint issues), there are things that you can still do comfortably, and things that increase the discomfort or that you now find difficult. These can often be really simple things like getting dressed, lifting the kettle or going upstairs. If you are able to think of these things as your body having to perform a job or move/use a ‘load’, it might start to make sense.

The best way to think about your complaint (elbow, knee or shoulder etc.) is that it has found itself with less ability to cope with the things (or cope with the ‘load’) that you used to do easily.

Ok, I’ve got it, but what does it mean for my particular issue?

Most of the time, these problems are nothing to be concerned about (even the really painful ones), but can be very frustrating as the discomfort gets in the way of doing normal things.
Fortunately, most problems can improve by themselves without physios or doctors, but sometimes we have to do something different to help them settle down and recover.

Why have I got this problem?

That is often a very difficult question to answer and interestingly, it is likely that only you know. Problems can come about through various ways such as injuries, overuse or even underuse.

Interestingly, it is quite common for tendon-related issues to arise due to doing more of something, doing something you’re not used to, or more likely, not being able to cope with certain activities due to reduced fitness and strength.

Ok, but what does this mean for me?

We all have a wonderful body that for the most part, does everything we want and need it to do.
You can normally pick up a cup without your arm aching, you can normally walk up a slope without your hip hurting and you can normally get dressed in the morning without your shoulder complaining. However, sometimes these things do become a problem and often the reason is that before the start of the issue, you may have done something more, or different, or not been as fit as before, and that has pushed your body’s ability to cope and it is now complaining about it.

What should I do?

Firstly, try not to worry. Discomfort can be really scary, especially when it is really sore or is getting in the way of things that you used to find easy. It is well known within the health professions that worrying about an issue can actually make it worse! (Mallows et al., 2018)

Secondly, in order to settle the issue, you need to consider looking at the things that your problem doesn’t like - the things that make it sore - and try to make some adjustments. Try to think along the lines of ‘if it hurts to do it this way, how else could I do it?’. Below are some ideas that may help, but do not feel that you need to limit your self to these.

Is this really that important?

In short, yes. With a lot of problems, this is one of the most important parts of your recovery. Making simple changes to the things that you find uncomfortable will allow your issue to calm down.

Is this all I have to do?

That would be nice, wouldn’t it? Unfortunately, if you only make adjustments to those things that are sore, you may find that when you go back to doing them normally again, things may become sore again.

How do I get stronger?

If you are working with one of our physiotherapists, they will advise on a programme of exercises that are right for you. If you are not working with a physiotherapist or want to explore some of the options for yourself, please explore our exercise libraries.

These can be found here: ‘Self-help’

Summary

• Your body has an amazing ability to do what you want it to do normally without complaining

• Sometimes if you do more of something, do something different or are not as fit and strong as you used to be, you can push the body’s ability to cope

• Painful things often mean that something is simply irritated rather than damaged

• By making some simple changes with the things that are sore (asking for help, using the other arm, taking more regular breaks etc.), you can start to settle things down

• Making changes/adapting painful things are really important steps towards recovery

• Just making changes to things that are uncomfortable will help, but to really try and get better, you need to think about growing your body’s ability to cope with things and this means getting fitter and stronger