Jake Harrison Therapies

This week so far

Looking forward to the conference, catching up with folk & bringing back some great learning in to clinic.

Being strong in the gym and being ready to run, jump, and change direction are two very different things.

This is the gap that most rehab never actually closes.

Someone does the loading work, pain settles, strength improves, and then they go straight back to full training. No bridge. Just a jump back in. And six weeks later they’re back to square one wondering what went wrong.

Late stage rehab is about building that bridge.

This is where plyometrics and sport specific movement come in. Not because they look impressive. Because tendons and muscles need to be able to store and release energy fast, absorb sudden load, and respond to changes in pace and direction. That’s what sport and active life actually demand. Heavy slow resistance work alone doesn’t replicate that.

But here’s the part most people don’t hear about.

Before progressing into that phase properly, there are benchmarks worth passing first.

One of the most widely used in the research is the limb symmetry index using single leg hop testing. The general standard used across the literature is 90% symmetry between sides, across tests like the single hop for distance, triple hop, and crossover hop. The idea being that if the affected side is significantly underperforming compared to the other, the tissue isn’t ready for the demands of full training.

It’s not a perfect measure. But it gives you something objective to aim for rather than just going on how it feels that day.

And that matters. Because pain settling is not the same as being ready.

If you’re not sure where you sit in this process, that’s exactly the kind of thing worth getting assessed properly.

Where are you in your rehab right now? Drop it in the comments.

Postural assessments are dead.

At least the old school version is.

Standing someone still, looking at their shoulders, pelvis, feet or spine, then blaming their pain on “bad posture” is far too simple.

People are not built from the same template.

Your hip shape, hip socket depth, pelvis, rib cage, shoulder blades and spinal curves can all vary massively from the person next to you.

So what looks “off” on one person might just be completely normal anatomy for another.

That does not mean posture never plays a role.

But it does mean we need to stop acting like there is one perfect position everyone should fit into.

A better assessment looks at:

How you move.
What feels sensitive.
What you can tolerate.
What feels guarded.
What you want to get back to.

Because your body does not need to look textbook perfect.

It needs options, strength, confidence and a plan that fits you.

If you’ve been told your posture is the problem, DM me MOVE and I’ll point you in the right direction.

Once the aggravation has settled, the real work starts.

And this is where most people either get it wrong, or don’t do anything at all.

The tissue needs load. Progressive, controlled, meaningful load. Not light band exercises that never actually challenge anything.

This is the phase where heavy slow resistance training earns its place.

The principle is straightforward. You load the muscle and tendon slowly, through a full range, with enough resistance to actually create an adaptation. You build that load progressively over weeks.

A randomised controlled trial by Beyer et al. compared heavy slow resistance training directly against eccentric training in people with Achilles tendinopathy over 12 weeks. Both produced equally strong, lasting clinical outcomes. HSR also came out with higher patient satisfaction scores.

Similar findings have since been replicated across patellar, rotator cuff, and lateral elbow tendinopathy.

Why does it work?

Tendons and the tissue around joints adapt to the demands placed on them. If you never load them properly, they stay sensitised. They stay reactive. They keep responding to normal activity as though it’s a threat.

Progressive loading changes that.

It’s not about going heavy for the sake of it. It’s about giving the tissue what it needs to handle the demands you eventually want to put back on it.

Part 3 covers the final phase. Where the gym work meets the real world again.

What’s the one thing you’re trying to get back to?

What’s your motor control and strength in range like?