In tendon rehabilitation, what effect does graded loading have on symptom flare risk?

• A. It increases flare risk
• B. It reduces risk of symptom flare
• C. It has no effect
• D. It eliminates flares completely

Answer: (B)

Graded loading helps tendon rehab by using a cautious, progressive increase in mechanical load to stimulate the tendon’s adaptation without provoking a flare. Tendons respond to loading by remodeling their collagen and increasing capacity, but sudden or large increases in load can overwhelm the tissue, causing micro-damage and a rise in pain or symptoms. By starting with light, tolerable loads and gradually upping intensity, duration, and frequency while closely watching symptoms, you promote strengthening and better tendon tolerance. This controlled progression reduces the likelihood of a symptom flare during the rehab process. It’s not about guaranteeing zero flares—occasional minor flare can occur if overload happens—but the overall risk is lowered when the load is systematically increased within the patient’s pain tolerance.