Pain and Rehab Podcast Episode 7: Tendinopathy


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This podcast features Drs. Ray, Amato, and Miles discussing tendinopathy diagnoses, management, and more. Time Stamps: Introduction: 0:00 ICON Paper & Terminology: 2:00 Clinical Presentation: 14:00 Tendon Adaptation - Review Paper: 22:30 Expectations and the Rehab Process: 30:30 Programming Considerations: 39:00 What is not supported for treatment: 49:30 Summary/Conclusion: 1:02:50 References: Docking SI, Cook J. How do tendons adapt? Going beyond tissue responses to understand positive adaptation and pathology development: A narrative review. J Musculoskelet Neuronal Interact. 2019 Sep 1;19(3):300-310. Scott A, Squier K, Alfredson H, et al. ICON 2019: International Scientific Tendinopathy Symposium Consensus: Clinical Terminology. British Journal of Sports Medicine Published Online First: 09 August 2019 Practical Applications: We DO NOT recommend completely off loading the area Manage loading is the name of the game. Type of loads (dynamic vs isotonic/isometric) Volume variables (sets/reps - for resistance training but also based on sports such as running, cycling, swimming such as duration of training) Intensity (internal vs external and sport specificity) Frequency (days per week of training) Range of motion alteration / role of technique modification? Exercise selection Remember to treat the person not just the tendon (psychosocial correlates), especially as the rehab process is non-linear and providing strategies for accurately interpreting the meaning and management of symptom flares Passive modalities are not recommended NSAID, steroid injections, PRP/prolotherapy, and tennex surgery are not recommended

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